Clinical Data Specialist
4 weeks ago
Job Summary:
This role involves performing various tasks related to the certification process, including data acquisition, review of service requirements, and file maintenance. The successful candidate will work under the supervision of a licensed registered nurse and will be responsible for performing scripted clinical screening that does not require evaluation or interpretation of clinical information.
Key Responsibilities:
- Makes outgoing calls to hospitals to determine patient status, request discharge dates, and disposition.
- Sends faxes to hospitals with requests for clinical reviews and discharge needs.
- Monitors and attaches faxes on the fax server as assigned.
- Transfers messages and clinical reviews from voice mails into the UR system.
- Performs scripted clinical screening as assigned, following the Policy and Procedure for Scripted Clinical Screening.
- Verifies provider network status and clarifies incomplete or contradictory non-clinical data.
- Notifies providers of certification and reads the disclaimer.
- Communicates with MD offices, hospital medical records, and UR departments as needed.
- Documents all activities in the UR file according to procedure.
Requirements:
EDUCATION: High School Diploma or equivalent with some post-secondary education desirable. Courses in medical terminology preferred.
SKILLS: Knowledge of computers, fluent keyboarding, data entry in databases, word processing, and multiple line telephone systems. Bi-lingual helpful but not required.
EXPERIENCE: Experience in the healthcare industry, such as medical transcription. Successful completion of the URA orientation program and maintenance of minimal QA standards. 1-2 years experience or relevant education in the healthcare industry.
PERSONAL QUALIFICATIONS: Helpful and friendly telephone personality. Ability to proof written material accurately, accurate data entry ability. Ability to organize a large variety of tasks and prioritize as directed by UR Manager. Ability to work with a variety of professional staff and provide clerical backup as needed for that staff. Understanding of customer service.
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