Heritage Medical Associates

Gathers, via direct care and/or telephone encounters, clinical data and maintains documentation in the clinical record (initials/dates) to ensure accurate tracking of medical treatment, i.e. chief complaint, vital signs, allergies, medications, advanced directive, growth charts, pain score, health history - i.e. immunization records, allergy injection record, other; completes Comprehensive Health Assessment as indicated annually. Appropriately uses/operates/troubleshoots various equipment needed in delivering patient care i.e. scales (infant / adult), digital thermometer, EKG, pulse oximeter, oxygen/nasal cannula/mask, nebulizer, spirometer, Holter Monitor / event recorder, Snellen, audiometry, endoscopes/endoscopic accessories, patient monitoring, etc.. Schedules patients for tests, as ordered, and informs them as to what to expect, i.e. lab, x-ray/procedures, nuclear medicine, stress test i.e. Myoview, exercise, adenosine, and cardiac Holter monitor. Assembles encounter forms for the next business day, label paperwork with MRC / chart number for physician review, send paperwork to scanning as required, open mail and route faxes appropriately. Preferred experience and/or an understanding of electronic health records (EHR) i.e. Allscripts software

authorization specialist

Job Details Job Location Main Office (MO - 222 MOB) - Nashville, TN Position Type Full Time (32-40 Weekly Hours) Education Level Technical Diploma, Certificate or Degree Travel Percentage None Job Shift Day Job Category Health Care Description Job Summary This position performs routine clerical, administrative, and clinical duties within the scope allowed for TN state law. This position may be assigned to a specific clinic/provider and/or float to various clinics/providers based on business needs and must demonstrate the ability to work collaboratively and effectively with physicians, providers, fellow team members, patients, and the general public in the performance of all job duties. In addition to the duties listed below, the MA may be required to perform other related duties as requested/assigned at a level that meets and/or exceeds HMA expectations. MA must be customer focused and driven to grow and to further develop a working culture consistent with HMA's mission, vision and values and commitment to high standards of ethical and business conduct and compliance with all applicable laws and regulations and third party payer requirements. Responsibilities (include, but not limited to) CLINICAL <ul><li>Gathers, via direct care and/or telephone encounters, clinical data and maintains documentation in the clinical record (initials/dates) to ensure accurate tracking of medical treatment, i.e. chief complaint, vital signs, allergies, medications, advanced directive, growth charts, pain score, health history - i.e. immunization records, allergy injection record, other; completes Comprehensive Health Assessment as indicated annually</li><li>Notifies physician / provider and/or the Registered Nurse immediately of patient's status, pending lab test results, and any abnormal data/complaints observed or obtained from the patient - i.e. breathing difficulties, adverse drug reactions, medication effectiveness, etc. and administers CPR should the need arise; preps charts for physician(s) as instructed</li><li>Triages patients appropriately i.e. face-to-face encounter, phone calls and Follow My Health messages and informs physician/provider of issues in a timely manner</li><li>In accordance with established protocol/policy and consistent with the age of the patients served, properly prepares (correct dosages) and administers (sub-Q, intra-muscular, intra-dermal, intra-venous / infusion) medication, allergy serum, immunizations, O2, treatments, tests (flu, Mono, Strep, TB, etc.) as ordered; demonstrates knowledge and understanding of dosages, reactions, and side effects of medications; accurately documents in patient's chart</li><li>Correctly conducts CLIA waived testing i.e. glucose, UAs, pregnancy, strep, etc. as ordered; follows established lab protocol/guidelines i.e. controls (strep, urine, RSV, Flu, hemoglobin, cholesterol, lipid, A-disk, pregnancy, etc.)</li><li>Accurately follows established procedures for handling various specimens/cultures i.e. throat, wound, stool, urine, sputum, etc. and infection control in the handling and disposing of infectious/hazardous waste materials.</li><li>Appropriately uses/operates/troubleshoots various equipment needed in delivering patient care i.e. scales (infant / adult), digital thermometer, EKG, pulse oximeter, oxygen/nasal cannula/mask, nebulizer, spirometer, Holter Monitor / event recorder, Snellen, audiometry, endoscopes/endoscopic accessories, patient monitoring, etc.</li><li>Assists physician and/or provider with patient encounter including: patient education / instruction, lab tests, results, reports, etc. and with various procedures / set-up - i.e. pap and pelvic, lesion removal, biopsies, ear irrigation, colposcopy, etc.; keeps exam rooms stocked and room and equipment clean in accordance with established schedule</li><li>Calls in / e-scribes / prints prescriptions to pharmacies as ordered by the physician/provider and documents in the patient's chart accurately and timely. Maintains sample medications by checking refill lines timely, enters samples provided to a patient in the computer and documents appropriately; remove/dispose of expired medications; ensures sample medication and other medication and supplies are adequately stocked and maintained in locked/secured areas. Performs all job duties listed in this job description, as well as, other related duties as assigned/directed in a manner that ensures timely completion of clinic workflows, clinic operations, and navigating the patient through their encounter (in person/telephone/HMA patient portal); all work activities must promote patient satisfaction, efficiency, and a collaborative, team-spirited environment</li></ul> ADMINISTRATIVE <ul><li>Ensures sterile instrument processing is completed timely in accordance with established protocol and manufacturer recommendations i.e. check instrument expiration dates, cleans and disinfects equipment, accessories, and packages items</li><li>Accurately schedules patient appointments by:<ul><li>obtaining the required demographic information (i.e. guarantor, PCP, usual and referring physician);</li><li>informing patient of financial liability (i.e. outstanding balance, $100 payment), understanding Alert Notes;</li><li>informing patient of prep required for procedures (obtained from referral website) / labs;</li><li>obtains necessary consent forms</li></ul></li><li>Verifies provider insurance participation via referral website, HMA Insurance Analysts, and other applicable sources</li><li>Accurately utilizes the Appointment Management in PM including working bump, no-shows, cancellations, confirmations and wait lists and track initial specialist office visit appointment to ensure patients keep an appointment</li><li>Schedules patients for tests, as ordered, and informs them as to what to expect, i.e. lab, x-ray/procedures, nuclear medicine, stress test i.e. Myoview, exercise, adenosine, and cardiac Holter monitor</li><li>Completes patient referrals and authorizations in a timely manner prior to the patient's appointment and follows-up on pre-authorizations prior to the procedure</li><li>Timely follow-up on referrals and procedures in Orders Management</li><li>Utilizes insurance websites to obtain benefit information, referrals, pre-authorizations, etc.</li><li>Tracks all diagnostic studies to ensure results are received and patients informed of results as directed by the physician and /or the provider</li><li>Maintains a clean and orderly work area and adheres to Quality Control Guidelines such as monitoring medication refrigerator temperature, eye wash checklist, O2 checklist, AED checklist, and the autoclave checklist.</li></ul> CLERICAL <ul><li>Answers phones and returns phone calls/voice mail (within 24 hours) in a positive and professional manner ensuring customer needs are adequately addressed</li><li>Orders supplies/accessories timely to avoid shortages/outages which may impede the delivery of patient care services</li><li>Properly uses the copy machine and faxes ensures paper trays are filled, ink cartridges are replaced as needed, and maintenance is called if necessary</li><li>Completes HMA required forms accurately and timely i.e. Incident /Accident report, Occurrence report, Needle Stick report, clinic nursing forms, logs, mammogram, MME, etc.</li><li>Complies with HMA policies and procedures and accreditation agencies, OSHA, etc.</li><li>Assembles encounter forms for the next business day, label paperwork with MRC / chart number for physician review, send paperwork to scanning as required, open mail and route faxes appropriately</li><li>Reviews phone tree reports and conducts appointment-reminder calls as appropriate</li><li>Attends and actively participates in required clinic meetings, huddles, and training to remain current of operational / workflow changes and to further develop a skill set</li></ul> CUSTOMER SERVICE <ul><li>Displays sensitivity, courtesy, and respect when dealing with patients, team members, and the general public</li><li>Demonstrates a willingness to ensure customer questions are answered and their needs are addressed goes the extra mile to assist others and ensure the message delivered is received as intended</li><li>Exhibits behavior that is consistent with HMA's mission, vision, and values Interpersonal Skills</li></ul> Knowledge, Skills, and Abilities <ul><li>Ability to communicate clearly</li><li>Computer knowledge helpful</li><li>Preferred experience and/or an understanding of electronic health records (EHR) i.e. Allscripts software</li><li>Prior experience in a large multi-specialty physician practice preferred</li></ul> Qualifications Job Requirements <ul><li>High School Diploma or Equivalent</li><li>Possess a Degree, Diploma or Certificate of Completion from an accredited Medical Assistant training program (or accredited nursing program) or have a minimum of 1-year prior experience functioning as a Medical Assistant in a clinic/hospital setting, or completion of Medical Assistant type training in the armed services. </li><li>Current Cardiopulmonary Resuscitation (CPR) certification</li><li>If working as a float will need Valid TN Driver's License and Proof of Valid Automotive Insurance</li></ul> Physical Demands and Work Environment <ul><li>Must be able to stand for 8 to 10 hours a day</li><li>Requires regular walking, bending, pushing, pulling and lifting</li><li>Must be able to lift at least 25lbs</li><li>Must be able to assist patients with transfers from chair to wheelchair, to exam tables, and back to wheelchair/chair</li><li>Must be able to assist patient with turning/positioning on exam table</li><li>Must be able to push patient in wheelchair </li><li>Must be able to manipulate objectsreaching, grasping, handling</li><li>Must exhibit good communication skillsunderstand, respond and translate into action</li><li>Ability to delineate between numeric numbers</li><li>Clinical setting; exposure to communicable diseases, bloodborne pathogens, medical preparations and other conditions common to a clinical environment.</li></ul>

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