Office Specialist

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Responsible for patient registration, outpatient scheduling, insurance verification, insurance authorization, denial management, receptionist, Medicare certification/re-certification management, medical records management, phone skills, and other assigned clerical duties.

MINIMUM QUALIFICATIONS:

EDUCATION, CERTIFICATION, AND/OR LICENSURE:
1. High School Diploma or equivalent.
2. Current CPR certification is required upon hire or must be completed within the 90-day probation period.

PREFERRED QUALIFICATIONS:

EXPERIENCE:
1. Prior experience with patient registration/admission.
2. Prior experience with insurance verification and authorization.
3. Prior experience with electronic patient scheduling.

CORE DUTIES AND RESPONSIBILITIES: The statements described here are intended to describe the general nature of work being performed by people assigned to this position.  They are not intended to be constructed as an exhaustive list of all responsibilities and duties.  Other duties may be assigned.

1. Obtains demographic and insurance information accurately for pre-registration/intake processes.
2. Registers rehab series patients per admission standards.
3. Determines eligibility and benefits for requested services. Verifies insurance coverage in a timely manner & communicates results with the patient.
4. Obtains insurance authorization in a timely fashion. Communicates visits and to/from dates with the treating therapist(s).
5. Monitors authorized visits report, and notifies treating therapist when additional authorization is required.
6. Effectively communicates authorization numbers and to/from dates with the business office.
7. Actively participates in denial management by seeking retro-authorization when indicated, and communicating results to the business office as directed.
8. Seeks out physician signature for Medicare Plan of Care Certification/Re-certification.  Monitors forms signature status & communicates status to the business office.
9. Schedules patients in an effective & timely manner. Maintains/updates therapist schedules in electronic schedule system.  Coordinates multi-service appointments in an efficient manner.
13. Manages patient files and hard-copy forms as directed.
14. Obtains physician orders as needed.
18. Effectively performs all other clerical duties as directed.
19. Effectively serves outpatient reception duties.  Greets patients in professional, friendly manner.  Notifies therapists of patients arrival in a timely manner.
20. Directs self-pay patients that may quality for charity care to UHC’s Patient Representative.
21. Orders base non-salary expense and office supplies within budget guidelines.

PHYSICAL REQUIREMENTS: 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.

1. The National Institute of Occupational Safety and Health recommends minimizing the need for employees to manually lift patients, and limit safe patient handling to 35 pounds.  All transfers, lifts, and re-positioning will be completed utilizing the provided patient lift equipment as indicated by the patient’s clinical profile and appropriate algorithms for safe patient mobility.
2. Light Work- Must be able to sit for prolonged periods of time, and have the manual dexterity to type efficiently.
3. Visual and hearing acuity (with or without correction) must be within normal range.  Must be able to effectively communicate including frequent telephone use, and monitor the physical environment for patient, visitor, and staff safety

WORKING ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Office environment

SKILLS AND ABILITIES:

1. Ability to use multi-line phone system, including transferring calls and use of paging system.
2. Skill in use of office equipment including fax, scanners, copiers, computers, and telephone systems.
3. Must have strong organizational skills and the ability to multi-task.
4. Basic knowledge of computer programs such as word processing, spreadsheets, and email applications.
5. Basic knowledge of ICD-10 Codes and CPT Codes.
6. Knowledge of major payer payment provisions and policies.

Additional Job Description:

Scheduled Weekly Hours:

0

Shift:

Varied (United States of America)

Exempt/Non-Exempt:

United States of America (Non-Exempt)

Company:

UHC United Hospital Center

Cost Center:

210 UHC Physical Therapy

Address:

327 Medical Park DriveBridgeportWest Virginia

Equal Opportunity Employer

West Virginia University Health System and its subsidiaries (collectively "WVUHS") is an equal opportunity employer and complies with all applicable federal, state, and local fair employment practices laws. WVUHS strictly prohibits and does not tolerate discrimination against employees, applicants, or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including gender, pregnancy, sexual orientation, and gender identity), age, physical or mental disability, citizenship, past, current, or prospective service in the uniformed services, genetic information, or any other characteristic protected under applicable federal, state, or local law. All WVUHS employees, other workers, and representatives are prohibited from engaging in unlawful discrimination. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, training, promotion, discipline, compensation, benefits, and termination of employment.