Clerk, Denials Management at DHR Health

Summary

FLSA STATUS: ☐ Exempt ☒ Non-Exempt MISSION STATEMENT: Our Mission is to improve the well-being of those we serve with a commitment to excellence: every patient, every encounter, every time. VISION: Our Vision is to create a world-class health system to advance medicine and increase access for the communities we serve by empowering caregivers to heal through compassion, knowledge, innovation, integrated care and excellence.

Position Summary

Provides secretarial and administrative support services to Denials Team.

Position Education/ Qualifications

• High School Diploma/GED preferred Prefer hospital experience Office experience is preferred Organizational skills is necessary Good written and verbal communication skills required. Ability to read, write and speak English Ability to communicate clearly and concisely with all levels of nursing, administration, and physicians Prefer hospital experience Secretarial experience is preferred

Job Knowledge/Experience

High degree of competency/experience in general. Requires good communication and organizational skills. Requires reasoning ability and good independent judgment.

Requires working with frequent interruptions. Must project a professional image. Must possess working knowledge of personal computers and software applications used in job.

Position Responsibilities

• • Promotes the facility mission, vision and values by effectively communicating them to others.
• Considers mission, vision and values in developing services, standards and practices Able to perform the necessary functions on the facility computer system.
• Works collaboratively with Denials on report discrepancy.
• Establishes, maintains and revises record keeping and filing systems, ensuring confidentiality of information.
• Consistently is attentive to detail, record keeping and required paperwork inherent to the position.
• Prints/faxes correspondence reports in a timely manner.
• Accepts and screens telephone calls and routes calls appropriately.
• Informs management when the situation warrants immediate attention.
• Maintains Careport Log Informs Management on status of appeals from Careport Monitors & corrects any duplicate records in Careport Informs immediate supervisor of any delays in assigned tasks in Careport Other duties as assigned

Other Information

• LINES OF REPSONSIBILITIES: (Chain-of-command) Office Supervisor → Sr. Director → CFO → CEO

Customer Service

Provide excellent customer service to all DHR customers. All employees are required to attend the DHR C.A.R.E.S program which outlines the Customer Service Principals including: Commitment, Accountability, Respect, Excellence and Service.

Age Specific

Employees must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in his/her assigned unit. The individual must demonstrate knowledge of principles of growth and development over the life span and possess the ability to assess data reflective of the patient’s status and interpret the appropriate information needed to identify each patient’s requirement relative to his or her age.

Americans With Disabilities Act

(ADA): A.

Essential Duties

• Indicated by bold print within performance standards, preceding individual numbered criteria.
• The following table provides physical requirements that will be associated with, but not limited to, this position: Light/moderate lifting up to 20 lbs, from the floor to shoulder height.
• Yes Kneeling Yes Must be able to assist other employees with lifting more than 20 lbs.
• Yes Walking Yes Light/moderate carrying up to 20 lbs.
• Yes Standing/Squatting Yes Straight pulling Yes Sitting Yes Pulling hand over hand Yes Pushing Yes Repeated bending Yes Stooping/Bending Yes Reaching above shoulder Yes Climbing Stairs Yes Simple grasping Yes Climbing Ladders No Dual simultaneous grasping Yes Depth Perceptions needed Yes Ability to see Yes Identify Colors Yes Operating office equipment Yes Twisting Yes Operating mechanical equipment Yes Crawling No Ability to read and write Yes Ability to Count Yes Ability to hear verbal communication without aid Yes Operating Personal Vehicle Yes Ability to comprehend written/verbal communication Yes Other: Ability to deal with stress Yes OSHA Category III B.
• Working Conditions: The individual spends over 95% of his/her time in an air-conditioned environment with varying exposures to noise.
• There is protection from weather conditions but not necessarily from temperature changes.
• The position does have low exposure to malodorous, infectious body fluids from patients and some minimal exposure to noxious smells from cleansing agents.
• C.
• Occupational Exposure: This position has minimal to no exposure to blood, body fluids, or tissues and is an OSHA Category III (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids).
• Person who performs these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.
• D.
• Aptitudes: HIGH 1 2 3 4 5 6 LOW Intelligence: General learning ability: The ability to “catch on” or understand instructions and underlying principles.
• Ability to reason and make judgments. 3 Verbal: Ability to understand meanings of words and ideas associated with them, and to use them effectively.
• To comprehend language, to understand relationships between words, and to understand meanings of whole sentences and paragraphs.
• To present information or ideas clearly. 3 Numerical: Ability to perform arithmetic operations quickly and accurately. 2 Spatial: Ability to comprehend forms in space and understands relationships of plane and solid objects.
• Frequently described as the ability to “visualize” objects or two or three dimensions, or to think visually of geometric forms. 2 Form Perception: Ability to perceive pertinent details and objects or in pictorial or graphic material to make visual comparisons and discriminations and see slight differences in shapes and shadings of figures and widths and lengths of lines. 3 Clerical Perception: Ability to receive pertinent details and verbal or tabular material.
• To observe differences in copy, to proofread words and numbers, and to avoid perceptual errors in arithmetic computation. 2 Motor Coordination: Ability to coordinate eyes and hands to fingers rapidly and accurately in making precise movements with speed.