Clerical Assistant

SUMMARY: The Clerical Assistant is responsible for delivering excellent customer service that is friendly, accurate and efficient. The Clerical Assistant is responsible for obtaining and entering accurate and complete insurance verifications, collection of co-payments and collection of past due balances, and other elements that make up the start of the Esperanza Revenue Cycle. The Clerical Assistant, as a critical part of the Clinical Care team, is responsible for accurate and directly with the public in person and via phone and is the starting point of the revenue cycle for clinic operations. The Clerical Assistant provides direct support services in the clinical care of patients and ensures effective and efficient operations to maximize patient satisfaction. The Clerical Assistant covers all aspects of Front Desk Reception, Hub Referral Clerical and Call Center roles and works late shift, Saturday shift, and rotates to all sites as assigned.

ESSENTIAL DUTIES AND RESPONSIBLITIES

1. Customer Service: The Clerical Assistant is responsible for delivering excellent customer service that is friendly, accurate and efficient.

1. Arrives on time to assigned area, ready to work. Does not leave work station unnecessarily. Communicates with team when stepping away from desk. Participates in departmental, hub and staff meetings; reads administrative emails/memos to be informed of changes, leading to better customer service and team unity.
2. Ensures adequate clinic coverage by working late shift, Saturday shift, and rotating to all sites as assigned.
3. Welcomes patients and visitors warmly in person and on phone. Demonstrates courtesy, respect, patience, and the love of Christ in every interaction, even when patient is demanding or rude.
4. Logs into MXIE promptly as assigned. Ensures adequate phone coverage by only logging and utilizing “Not available” per manager instruction.
5. Answers phone calls promptly and verifies full name, DOB, phone numbers and insurance information with each interaction. Follows EHC guidelines for holds and transfers, always communicating actions clearly to patient.
6. Uses excellent listening skills and clarifying statements to better understand patient. Offers support, hope, and comfort to patients using compassionate responses, prayer and scripture when appropriate.
7. Accepts ownership of problems and offers prompt resolution with humble and sincere apology.
8. Keeps work area properly stocked, neat and organized and labels all unfinished work at end of day for follow-up in order to provide efficient care of patient needs.
9. Checks-in patients at front desk in a timely and accurate manner, updates demographics at each visit, verifies identity and insurance cards, takes patient photo in EMR, obtains signatures on requisite forms annually, scans forms and IDs at the front desk and assures that information has been entered into Centricity, verifies guarantor set-up in account.
10. Assists patient in fully and accurately completing registration forms at first visit and at least once annually. Updates information in Centricity account and scans papers into account.
11. Assures that Sliding Fee Scale information is in account so that additional discounts can be applied. If patient has not supplied household income previously, explains necessity of this information and ask for updates.
12. Familiar with various forms (demographic, school, disability, welfare, utility forms, etc.). Directs patient to complete their portion before accepting form for provider. Assist patients with low literacy level to complete forms.
13. Offers appropriate scheduling options to patients in accordance with EHC scheduling rules for all appointment types. Explains NPE process, 7 day/ Same Day/Next Day appointment in a clear and concise manner. Familiar with the age limitations, credentialing status and specialty appointments of each clinician so that appointments are made correctly. Familiar with the insurances accepted by EHC so that patients are not given an appointment if we do not accept that insurance.
14. Reminds patient to bring insurance card, ID card, and co-pay (advises if higher specialist co-pay applies), medications, and insulin log to every appointment.
15. Verifies that patient questions have been answered. Assures that patient understands what to bring to appointment and has directions and parking instructions. If patient does not have information at the time of the call, informs patient to obtain/bring required information and documents this in appointment note.
16. Engages interpreters as needed to decrease patient barriers.

2. Revenue Cycle: The Clerical Assistant is responsible for obtaining and entering accurate and complete insurance verifications, collection of co-payments and collection of past due balances, and other elements that make up the start of the Esperanza Revenue Cycle.

1. Verifies eligibility on all active insurances prior to patient encounter. Verifies PCP assignment, copayments and coverage limitations prior to encounter. Sets insurance order for appointment, and assures that allocation set and financial class match primary insurance. Verifies that patient name and DOB exactly match primary insurance, and that insurance product chosen in account is the actual plan assigned to patient on website.

1. Provides written record of insurance verifications from external websites, including name of website, eligibility response, PCP assignment, other payers on account, CA name and date.
2. Establishes mental health coverage prior to each medical or BHC encounter and adds the mental health insurance to account.
3. Asks if visit is related to MVA or Worker’s Comp at check-in and collects MVA and WC information as needed. Creates or attaches “cases” for all worker’s comp, MVA, and other visits per protocol.
4. Obtains signature on Authorization for the Release of Information for all MVA and WC cases and documents this in the finance tab.
5. Enforces collection policy by assigning guarantor correctly, collecting co-payments prior to visit and issuing receipt. Takes steps to initiate payment plan for past-due balances. Refers uninsured patients to the Patient Access Liaison for evaluation.
6. Practices sound accounting and cash management principles by reconciling Daily Deposit slip and Daily Logs with cash totals at the end of each shift. Reconciles any discrepancies immediately. Manages case drawer: Keeps drawer locked at all times. Requests change from Office Manager as needed. Assures that change is ready for Saturday clinic.
7. Retrieves charges and performs “first scrub” of claims at check out, verifying insurance order, allocation set, and case attachment. Communicates directly with clinician if charges have not been entered. Creates financial note in account to clarify any transactions that may be problematic.
8. Creates new patient accounts using mini-registration module. Begins by searching database by “any” search function to avoid chart duplication, using EHC business intelligence tool for NPE availability and age restrictions, using insurance web-sites to verify eligibility and PCP assignment, and using EHC credentialing status updates for new clinician insurance assignments at EHC.

3. CLINICAL SUPPORT: The Clerical Assistant, as a critical part of the Clinical Care team, is responsible for efficient / accurate work, population management, and risk management.

1. Verifies patient FULL NAME and DOB before opening EMR, sending message or scheduling an appointment.
2. Reads and responds to pop-up notes each time account is opened. Erases notes when obsolete.
3. Follows scheduling rules for all types of visits and all types of resources. Understands exception rules so that resources are used appropriately.
4. Utilizes “Clerical Assistant’s Guide to Scheduling Acutely Ill Patients in Advanced Access Model” document to schedule patients with acute symptoms. Utilizes EHC business intelligence tools and Centricity search function to offer appropriate appointment options.
5. Routes Phone notes appropriately for refills, medical questions, referrals, DME, social services, return calls, and many more things.
6. Follows protocols for handling calls from specialists, hospital, visiting nurses, Stat labs (also known as Critical lab value), and suicidal calls.
7. Maintains confidentiality in accordance with HIPAA law, never releasing patient information to a person not authorized by HIPAA
8. Does not attempt to answer clinical questions and does not give medical advice
9. Familiar with referral requirements of each insurance company. Completes all routine referrals within 48 hours of request. Gives patient all relevant specialist appointment information (specialist name, address, phone number) so that patient can make and manage their own referral appointment. Assists patients who experience difficulty making specialist appointments. Submits copy of on-line referral for scanning into chart.
10. Sends Transition of Care documents following EHC procedures
11. Makes specialist appointments for all “High Risk” referrals according to protocol.
12. Notifies Patient Access Liaison when a prior-authorization is required for the referral. Informs patient when Prior-authorization has been obtained.
13. Reads proxy box messages within 24 hours. Follows up at least once per day until completion, documenting steps of each transaction.
14. Works to meet organizational productivity goals by contacting patients most likely to “No Show,” and consulting with team to add squeeze-ins or see late arrivals according to most recent policies.
15. Maintains schedule accuracy by updating status on all appointments by end of day and following procedures for handling “no shows” and cancellations.
16. Write name, DOB and account number on documents sent to scanning.
17. Adheres to walkie-talkie protocol.
18. Follows sound principles of medical/legal documentation.
19. Secures all patient information in accordance with HIPAA by using screen protectors, logging out of EMR when stepping away from desk, and securing or shredding paper at the end of shift.
20. Follows EHC guidelines for incident reporting and OSHA safety.

1. Other duties as assigned by supervisor

Education, knowledge, skills, and qualifications

• High school diploma or GED.
• At least one year of experience in customer service, with experience handling difficult customer issues.
• Skilled in using computer and related equipment; ability to type quickly and accurately
• Demonstrated ability to handle many details and multiple priorities. Must show ability to organize, process, and verify details.
• Good oral and written communication skills. Must be fully bilingual in English and Spanish.
• Must have a solid record of handling confidential information, as well as demonstrating trustworthiness and honesty in all transactions.
• Solid record of timeliness and reliability in a work setting.
• Able to integrate Christian faith with work and pray with others in need.

WORKING CONDITIONS

• Requires the ability to sit at desk, read fine print on the computer, type and use computer keyboard for all or most of assigned shift, and operate the desk phone for extended periods of time.
• Requires the ability to work late shift, Saturday shift, and rotates to all sites as assigned.
• Requires the ability to climb stairs, walk, and move around a room.
• Requires the ability to lift 20 lbs.