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Claims Resolution Specialist Internal Resolution Unit PCHP
United States · On-site
Senior
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Full-time
Posted 10d ago
~40 hrs/week
Responsibilities
The Senior Medical Practice Assistant serves as a lead worker, coordinating clinical activities and facilitating patient flow to ensure optimal care. They also provide training, monitor performance indicators, and act as an expert resource for patient intake and clinical support services.
Requirements
Candidates must have at least five years of customer service experience, including two years in a medical practice environment. Proficiency in medical terminology, diagnostic coding, and basic office software is required, along with the ability to pass specific typing and spelling assessments.
Full job description
Senior Medical Practice Assistant
Primary Purpose
Serves as a lead worker to Medical Practice Assistants, providing patient-centered care and operational support to the medical team to ensure an optimal patient experience. Coordinates activities in the clinical areas and facilitates a smooth patient flow. Assists with patient data collection, performs select screenings, and completes medical office functions relevant to the area/assignment.
MINIMUM SPECIFICATIONS
Education
None
Experience
Must have five years of customer service experience, preferably in a medical/healthcare/health insurance setting.
Must have two years of experience in a Medical Practice environment.
Patient registration experience preferred.
Prefer completion of coursework towards an accredited medical terminology program.
Medical Office Assistant experience or training is a plus.
Virtual Care Only
Must have 2 years of experience in virtual care or telehealth support.
Certification/Registration/Licensure
School-Based Health - Youth and Family Services Only (Cost Center 40270)
Must have a valid Texas Class C Driver's License.
Required Tests for Placement
Must demonstrate ability to type 20 words per minute with a maximum of 3 errors.
Must be able to successfully pass a Spelling Test with a minimum score of 85%.
Skills or Special Abilities
Must be able to work collaboratively with colleagues to deliver patient/customer services that exceed patient expectations as evidenced by patient satisfaction scores.
Must be able to demonstrate competency required as applicable to the specialty area.
Must have demonstrated communication skills to include above-average verbal skills (heavy public contact) and written skills. Bilingual skills preferred.
Must have a working knowledge of diagnostic ICD-9-CM coding and HCPCS-CPT4 procedure codes.
Must have a thorough working knowledge of medical terminology.
Must have basic knowledge of medical software.
Must demonstrate a positive demeanor, good verbal and written communication skills, and be professional in both appearance and approach.
Must be able to demonstrate intermediate-level clerical skills and a working knowledge of standard office equipment.
Must be detail-oriented and have sharp analytical skills to resolve registration issues as related to multiple groups, including third-party payors, physicians, patients, and the system.
Must be able to solve problems within the guidelines of established policies and procedures.
Must be able to adjust to multiple demands, shifting priorities, and rapid change.
Virtual Care Only:
Confident with technology, specifically electronic medical records, video encounters, and computer applications
Must be able to work collaboratively and optimally with patients with serious health conditions and barriers to care.
Responsibilities
Serves as a lead worker for Medical Practice Assistants to include training, scheduling, monitoring, and completing Performance Indicator Reports, and other reports to maximize productivity and compliance within the department.
Serves as acting supervisor for staff as needed, on weekends, rotating holidays, or anytime a shift needs coverage in the absence of a regularly scheduled supervisor.
Acts as primary preceptor and provides general and topic-specific training to employees when changes in guidelines occur.
Provides re-education to department staff based on the results of reviews to correct potential weaknesses and ensure ongoing compliance.
Ensures documentation exists to evidence training has occurred.
Collaborates and assists with the coordination of operational activities to support clinical operations.
Serves as an expert resource for patient intake/inquiries and the assessment of patient needs related to clinical support services.
Performs all related Medical Practice Assistant duties and patient service activities in coordination with the clinical team, and in an expert manner.
Assists with oversight in the day-to-day coordination of clinic/area activities and facilitates clinical support processes according to standards, and has the ability to support all service needs.
Proficiently performs delegated technical functions, including but not limited to
Obtains and/or records initial patient data, including reason for visit, height, weight, allergies, etc., as trained, and reports data to the appropriate healthcare team member.
Practices patient safety measures in association with site leadership
Complies with proper hand hygiene (hand washing/hand sanitizer gel/foam use).
Applies or practices proper infection control methods.
Identifies, corrects, and/or reports safety hazards at the time of discovery.
Identifies and/or facilitates maintenance of equipment, initiates work orders, and removes equipment from the patient care area, as appropriate.
Informs Environmental Services when additional cleaning activities are needed.
Participates in performance improvement and quality initiatives.
Participates in the unit performance improvement initiatives.
Meets expected performance quality measures as outlined for area(s) or responsibility.
Identifies ways to improve work processes and improve customer satisfaction.
Makes recommendations to supervisor, implements, and monitors results as appropriate in support of the overall goals of the department and Parkland.
Stays abreast of the latest developments, advancements, and trends in the field of Medical Practices by attending seminars/workshops, reading professional journals, actively participating in professional organizations, and/or maintaining certification or licensure. Integrates knowledge gained into current work practices.
Maintains knowledge of applicable rules, regulations, policies, laws, and guidelines that impact the Medical Practice.
Develops effective internal controls that promote adherence to applicable state/federal laws, and the program requirements of accreditation agencies and federal, state, and private health plans.
Seeks advice and guidance as necessary to ensure proper understanding.
Based on operational need, you may be required to perform the role in an alternate Parkland location.
Related keywords
Medical Practice AssistantPatient CareClinical OperationsMedical TerminologyICD-9-CMHCPCS-CPT4Electronic Medical RecordsCustomer ServicePerformance ImprovementInfection ControlPatient SafetyData CollectionHealthcareTelehealthVirtual CareCompliance
Parkland Health first opened its doors in 1894 and is now one of the largest public hospital systems in the country. The hospital averages more than 1 million outpatient visits annually. Services include a Level I Trauma Center, the only verified burn center in North Texas and a Level III Neonatal Intensive Care Unit. The system also includes 20 community-based clinics, including primary care and women's clinics, 12 school-based clinics and numerous outreach and education programs. Parkland is the primary teaching hospital for the University of Texas Southwestern Medical Center.
Despite our growth for more than 100 years, our mission and vision remain the same – to care for you and your family. Thank you for choosing Parkland.
Offices: 5200 Harry Hines Blvd., Dallas, Texas 75235, US
Level I Trauma CenterBurn CenterNeonatal Intensive CareCommunity Oriented Primary CareSpinal Cord InjuriesEndocrinologyEpilepsy CenterCardiologyOncologyWomen's and Children's Services
Parkland Health first opened its doors in 1894 and is now one of the largest public hospital systems in the country. The hospital averages more than 1 million outpatient visits annually. Services include a Level I Trauma Center, the only verified burn center in North Texas and a Level III Neonatal Intensive Care Unit. The system also includes 20 community-based clinics, including primary care and women's clinics, 12 school-based clinics and numerous outreach and education programs. Parkland is the primary teaching hospital for the University of Texas Southwestern Medical Center.
Despite our growth for more than 100 years, our mission and vision remain the same – to care for you and your family. Thank you for choosing Parkland.
Offices: 5200 Harry Hines Blvd., Dallas, Texas 75235, US
Level I Trauma CenterBurn CenterNeonatal Intensive CareCommunity Oriented Primary CareSpinal Cord InjuriesEndocrinologyEpilepsy CenterCardiologyOncologyWomen's and Children's Services