Revenue Cycle Clerk - Temporary F/T

GOALS FOR THE POSITION: (1) To provide clerical and data entry support to the Patient Accounts Department. (2) To support the timely processing of patient invoices (3) To provide excellent customer service for K’ima:w Medical Center patients.   

SUMMARY: Provides the highest level of customer service to K’ima:w Patients. Works as a liaison between K’ima:w Medical Center’s Revenue Cycle department and contracted lab provider to process patient invoices. Assists Revenue Cycle Manager and Billing Supervisor in timely processing of claims and A/R functions.

FUNCTIONS & RESPONSIBILITIES: 

• Reviews patient invoices and locates required information.
• Reviews provider notes to identify supporting ICD10 codes.
• Independently determines patient eligibility for Medicare, California State Medicaid, Department of Veterans Affairs, Third Party Liability, Workmen’s Compensation, Private Insurance, CHDP Gateway, Covered California, BCCTP, Presumptive eligibility and any other applicable resources.
• Follows up with Providers, K’ima:w lab, and patient benefits staff to obtain/correct any missing or incorrect information
• Uses EHR/Scheduling System/Billing System daily to verify all information before submitting patient bills/invoices.
• Submits and tracks billing form for all outsourced labs through third party billing portal.
• Tracks all patient bills and invoices for outsourced labs, provides weekly status reports to revenue cycle manager.
• Follows up with outsourced lab provider in a timely manner to ensure the billing process has been completed.
• Assists Revenue Cycle with various tasks as needed
• Other duties as assigned

QUALIFICATIONS: QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable with disabilities to perform the essential functions.

JOINT COMMISSION RESPONSIBILITIES: Responsible for helping to prepare, achieve, and maintain accreditation by the Joint Commission on Accreditation of Healthcare Organizations.  By serving on the various performance improvement subcommittees individual employees are directly involved in the generation or modification of policies & procedures that enable KMC to provide continuously improving healthcare.

PUBLIC RELATIONS/ADVANCED INTERPERSONAL SKILLS: Addresses clients by name; smiles when talking to clients, physicians. Peers, and families; answers the telephone courteously and promptly; identifies self and department when answering the telephone using pleasant voice tone/verbiage; possesses excellent listening skills; interacts with clients and peers.

COOPERATION: Must be a self-starter; seeks solutions; accepts constructive criticism; willing to adjust to changes; loyal to K’ima:w Medical Center.

PROFESSIONALISM: Shows pride in personal appearance and grooming; displays a positive attitude about work; respects the confidentiality of clients; and is congenial with public and peers.

INITIATIVE: Willing to participate in continuing education programs; asks questions; contributes during staff meetings; serves on K’ima:w Medical Center committees as appointed, demonstrates a desire for self improvement.

JOB SPECIFIC SKILLS & ABILITIES:

• Understanding of medical terminology.
• Demonstrate skill in operation of computer, calculator, and other office equipment.
• Demonstrate ability to work independently, establish priorities and meet deadlines.
• Demonstrate knowledge of maintaining and managing files and records.
• Demonstrate high level organization and prioritization skills.
• Demonstrate the ability to work with in a team setting; coordinating care and communicate with others on the staff is critical.

EDUCATION and/or EXPERIENCE:

• High School Diploma or equivalent G.E.D.
• One to two years related experience and/or training, or equivalent combination of education and experience preferred but not required.
• Knowledge of RPMS, BPRM, and IHS-EHR or a database computer system preferred but not required.   

CERTIFICATES, LICENSES, REGISTRATIONS:

Current CPR Certificate

Valid California Driver's License

CONFIDENTIALITY:

Employees must be aware of and adhere to K’ima:w Medical Center’s Confidentiality Policy and always deal appropriately with patient confidentiality.

CONDITIONS OF EMPLOYMENT:

Employee is subject to baseline and random drug testing per the Hoopa Tribal Drug & Alcohol Fit for Duty Policy.  Employee will serve a 90-day introductory period.  Employee is subject to introductory and semiannual performance evaluations.  Preference will be given to qualified Indian applicants pursuant to the Tribe’s TERO Ordinance.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

WORK ENVIRONMENT: 

The work environment characteristics described here are representative of those and employees encounter while performing the essential functions of this job.  Reasonable accommodations may be make to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is occasionally exposed to bloodborne pathogens, airborne formites, infections, and other contagious diseases and outside weather conditions.  The noise level in the work environment is usually moderate.

ANNUAL TRAINING REQUIREMENTS:

At a minimum Employee is required to be certified for the following training:

KMC Annual Orientation, to include infection control, safety, & personnel policies, etc.

CPR every two years.