Clinic Office Assistant in Southern Pines, North Carolina at FirstHealth of the Carolinas

Manages scheduling of appointments. Checks patients in and out and uses accurate and appropriate ICD-10 and CPT codes. Registers patients, prepares charts, posts charges and payments, collects co-payments. Maintains current database of patients demographics and billing information. Verifies insurance eligibility. Processes patient referrals for tests and referrals to specialists.

Position Specific Competencies: Clinic Office Assistant

In addition to the following essential position competencies, other competencies may be required to meet changing organization needs.

1. Uses an appropriate problem-solving approach to plan services.

1. Uses electronic medical records in a clinic setting demonstrating progressive efficiently with this method of technology.

1. Answers phones, routes calls and or takes accurate message. Adapts to a phone menu if one is in use. Demonstrates a sense of urgency relating to patient’s level of distress.

1. Triages basic patient care needs generating a telephone encounter depending upon the situation.

1. Manages the scheduling of patient appointments. Registers new patients and maintains current accurate up to date demographic and insurance information for all patients. Performs according to policy regulations associated with Privacy Notification, Medicare secondary, signed demographic registrations, consent to treat minor, etc. (MSPQ).

1. Contributes to plan of care for individuals and groups of patients utilizing all principles to reduce medication errors when handling or calling in medications or refills.

1. Prepares and maintains exam rooms and medical equipment for patient visits regarding all safety checks and HIPAA guidelines and adapt same HIPAA principles to chart documentation and exposure as well as discussing PHI in front of anyone other than patient.

1. Triages patients and enters accurate and concise data into the EMR while paying attention to spelling and clarity

1. Navigates the EMR systems in an efficient manner.

1. Facilitates quality care management though best practice utilization of the clinic EMR.

1. Promotes continuity of care seen by appropriate action notes and prompt follow up.

1. Answers phones, routes calls and/or takes accurate messages. Demonstrates a sense of urgency relating to a patient’s level of distress.

1. Triages basic patient care needs, generating a telephone encounter depending upon the situation. Assure a duplicate message has not already been started.

1. Identifies barriers related to Social Determinants of Health (SDOH) and notifies provider.

1. Identifies barriers to communications.

1. Verifies insurance eligibility, scans insurance card, and photo ID.

1. Checks patients in and or out for visit in appropriate manner. Accurate and appropriate use of ICD-10 and CPT codes.

1. Posts charges and payments accurately and accordingly to policy.

1. Accurately and accordingly to policy, posts payments.

1. Reconciles all financial data correctly and in compliance with clinic policy, both at the end of day and end of month.

1. Forward requests for Medical Records to Health Information Management Systems.

1. Works with patient and clinic manager to effectively manage patient accounts and performs certain financial assistance tasks as delegated and monitored by the clinic manager.

1. Recognizes how fraud and abuse interplay into daily roles.

1. Provides clinical coverage and performs duties within scope of COA (Clinical Duties)

1. Assists as needed with any medications pre-authorization and or appeals in a timely and appropriate manner.

1. Any other duty as assigned but within the scope of practice for a MOA by the clinic manager and or provider.

1. Provides services with consideration of the recipient’s needs.

1. Maintains work area in a neat and organized manner.

1. Ensures that patients are placed in exam rooms and seen by the provider in a timely manner.

1. Assists the provider as needed with examinations and procedures.

1. Assists in the collection of laboratory specimens and performance of tests on patients as ordered by the provider. Track lab and all tests for outcomes and follow-up.

1. Identifies clinical significance of data and informs provider appropriately and provider follow up with accurate documentation.

1. Ensures that all lab results, interpretation, etc., are received in the patient’s chart in a timely manner. Always assess provider signature, patient notification, date, and any required follow up.

1. Actively participates in department functions by suggesting strategies to improve outcomes, control costs, and/or increase patient satisfaction.

1. Secures patient information in desk drawers or folders.

1. Secures all receipts, cash drawer, etc. under lock and key overnight and when away from work area. Locks computer system as needed when away from work desk to protest PHI for patients

1. Greets and direct patients and visitors in a courteous manner, informing them of delays or changes in patient flow

1. Manages appointment schedule to ensure provider efficiency and patient satisfaction.

1. Monitors the reception area to ensure patient comfort and prompt response to patient distress or concerns

1. Wears FH name badge and introduces self to patient as needed and required by the situation.

1. Works on behalf of the patient to ensure timely appointments by asking patient to arrive early, effectively work through paperwork, history forms, etc. while making sure patients have the opportunity to re-schedule if provider is running late.

1. Monitors and manages patient requests for appointments within in-baskets (MyChart requests).

1. Manages no shows; monitors upcoming schedules, places reminder phone calls to patients 24 hours in advance, monitors daily schedule for no shows and late cancellations, mails no show letters. Communicate with providers when patients have multiple no shows.

1. Uses equipment/supplies correctly.

1. Maintains equipment in proper working order. Follow manufacturers’ manuals for care of office equipment. Notify manager of equipment failure.

1. Maintains adequate supply of materials and forms. Use supplies conservatively

1. Keeps a neat orderly and safe work area.

1. Uses appropriate safety and infection control measures.

1. Adheres to established infection control measures.

1. Assures patient safety by following applicable patient safety goals.

1. Ensures that all OSHA regulations and other appropriate policies are followed

1. Actively participates in the established QI/Risk Management Program.

1. Wear gloves and follow Body Substance Isolation Standards whenever examining the patient or in contact with blood/body fluids.

1. Ensures all needles are placed in sharps containers and all material with blood or body fluids are disposed of properly.

1. Ensures that all exam rooms and equipment are thoroughly cleaned between patients.

1. Teaches/directs/advises/informs others in an appropriate manner.

1. Communicates clearly with providers, manager and co-workers and patients.

1. Educate and inform patients about clinic policies, procedures and processes using basic simple language and principles of adult learning.

1. Involves clinic manager in all patient concerns/complaints in a timely fashion after first trying to diffuse the situation.

1. Accurately collects co-pays and deductibles; provides patients with necessary information about their insurance policy (when information is available) as needed and directed by the situation.

1. Accurately and clearly communicates data to the appropriate healthcare provider in a timely manner.

1. Utilizes EMR to support patient education and documents accordingly.

1. Advises patients in need of insurance pre-certifications or authorization for clinic visits (i.e., managed care and VA).

1. Knowledge of managed care plans.

1. Reports/records information appropriately.

1. Uses approved format for recording and reporting messages. i.e., telephone encounter, etc.

1. Maintains written reports of all situations requiring manager’s attention

1. Reconciles cash receipts and reports as instructed by policy when MOA must leave money drawer for an extended period.

1. Monitors habitual no shows or late patients, reporting and communicating, as needed to clinic manager.

1. Enters and records patient information in EMR in a concise and accurate manner.

1. Ensures that all test results, interpretations, etc., are received in patient EMR in a timely manner.

1. Utilizes reports and data generated by the EMR to augment care by seeking out patients who need specific follow up such as but not limited to annual mammograms, colonoscopy, etc.

1. Uses approved format for recording and reporting messages. i.e., telephone encounter, etc.

1. Maintains written reports of all situations requiring managers' attention.

1. Utilizes the EMR system if in place to facilitate role as it related to referrals, follow-up patient instructions or other activities required in a clinic setting to augment quality for patient care and coordination.

1. Quality Improvement

1. Will contact facilities as necessary to ensure the appropriate paperwork is index in the patient’s EMR medical record prior to being seen by the provider in preparation for patient appointments – Examples: surgical reports, pathology reports, home health summary of care, etc.

1. Responds to the follow-up action plans sent by providers goaled at achieving maximum level of care continuity in preparation for designated patient appointments. (Examples: Remind patient to bring blood pressure log to appointment.)

1. COA will monitor and utilize as needed the Quality Panel Metrics/Health Maintenance tab to facilitate proactive management of patient care and close care gaps.

1. BLS required and SPICE (not required – but employees will be required to complete at some point).

1. In addition to state job description above, the COA will also be accountable for the following duties:

1. Promote proactive communication with all patients while being sensitive to those that are high risk and whose care is complicated by:

• Recent inpatient admission to hospital

• Non-Compliance

• Uncontrolled chronic co-morbidities

• Problematic no-show rate

COA will also monitor the Quality Panel Metrics Health Maintenance Tab to facilitate proactive management of patient care and close care gaps.

Compliance with competencies is evaluated by Outstanding, Successfully and Needs Improvement. It is the judgment of the clinic manager and supported by objective documentation under comments when either Outstanding or Needs Improvement are given to any of these competencies.