Billing & Client Services Specialist Job Listing at Baton Rouge General in Baton Rouge, LA (Job ID 2013588368)

Description

JOB PURPOSE OR MISSION: Processes client inquiries and/or concerns in a professional, prompt and cost-effective mannerfor the age population served, as defined in the department's scope of service.

 

PERFORMANCE CRITERIA

 

CRITERIA A:   Everyday Excellence Values - Employee demonstrates Everyday Excellence values in the day-to-day performance of their job.

 

PERFORMANCE STANDARDS:

• Demonstrates courtesy and caring to each other, patients and their families, physicians, and the community.
• Takes initiative in living our Everyday Excellence values and vital signs.
• Takes initiative in identifying customer needs before the customer asks.
• Participates in teamwork willingly and with enthusiasm.
• Demonstrates respect for the dignity and privacy needs of customers through personal action and attention to the environment of care.
• Keeps customers informed, answers customer questions and anticipates information needs of customers.

 

CRITERIA B:   Corporate Compliance - Employee demonstrates commitment to the Code of Conduct, Conflict of Interest Guidelines, and the GHS Corporate Compliance Guidelines.

 

PERFORMANCE STANDARDS

• Practices diligence in fulfilling the regulatory and legal requirements of the position and department.
• Maintains accurate and reliable patient/organizational records.
• Maintains professional relationships with appropriate officials; communicates honesty and completely; behaves in a fair and nondiscriminatory manner in all professional contacts.

           

 

CRITERIA C:  Personal Achievement - Employee demonstrates initiative in achieving work goals and meeting personal objectives.

 

PERFORMANCE STANDARDS

• Uses accepted procedures and practices to complete assignments. Uses creative and proactive solutions to achieve objectives even when workload and demands are high.
• Adheres to high moral principles of honesty, loyalty, sincerity, and fairness.
• Upholds the ethical standards of the organization.

 

     

CRITERIA D:   Performance Improvement - Employee actively participates in Performance Improvement activities and incorporates quality improvement standards in his/her job performance.

 

PERFORMANCE STANDARDS

• Optimizes talents, skills, and abilities in achieving excellence in meeting and exceeding customer expectations.
• Initiates or redesigns to continuously improve work processes.
• Contributes ideas and suggestions to improve approaches to work processes.
• Willingly participates in organization and/or department quality initiatives.

 

     

CRITERIA E:  Cost Management - Employee demonstrates effective cost management practices.

 

PERFORMANCE STANDARDS

• Effectively manages time and resources
• Makes conscious effort to effectively utilize the resources of the organization — material, human, and financial.
• Consistently looks for and uses resource saving processes.

 

     

CRITERIA F:  Patient & Employee Safety - Employee actively participates in and demonstrates effective patient and employee safety practices.

 

PERFORMANCE STANDARDS

• Employee effectively communicates, demonstrates, coordinates and emphasizes patient and employee safety.
• Employee proactively reports errors, potential errors, injuries or potential injuries.
• Employee demonstrates departmental specific patient and employee safety standards at all times.
• Employee demonstrates the use of proper safety techniques, equipment and devices and follows safety policies, procedures and plans.

          

     

JOB FUNCTIONS

 

ESSENTIAL JOB FUNCTIONS include, but are not limited to:

 

1. Serves as resource and client services representative for the System.

 

PERFORMANCE STANDARDS:

• Courteously answers the telephone within 3 rings and directs calls according to established procedures.
• Receives internal and/or external requests for information and/or assistance in resolving issues using proper telephone/client service techniques.

 

     

1. Assures client satisfaction and follow-up.

 

PERFORMANCE STANDARDS:

• Identifies and resolves client complaints and problems whenever they occur as determined by observation and as reported by phone and/or the online reference service ticket site.
• Provides information and/or resolves issues within scope of own knowledge and authority, within established timeframes while maintaining communication with the client throughout the process.
• Forwards other requests/issues to appropriate person(s), maintaining ownership of issue until final resolution is obtained.
• Ensure that client inquiries and/or complaints are responded to within one working day.
• Ensure that client complaints are resolved within three working days.

 

 

1. Demonstrates a thorough knowledge of the principles of the laboratory in order to answer client questions and/or concerns of laboratory testing, specimens, stability, etc.

 

PERFORMANCE STANDARDS:

• Identify issues with specimen types, missing patient demographics, and review laboratory requisition forms for completeness following sample processing.
• Understands various medical terms and laboratory tests.
• Aware of the factors that influence specimen integrity and test results.
• Demonstrates knowledge of the actions of various anticoagulants.

 

     

1. Provides a variety of clerical support functions.

 

PERFORMANCE STANDARDS:

• Maintains accurate and current files of all patient/client records, correspondence, reports, and information, as required.

 

1. Oversees billing function in the reference lab to ensure appropriate charging.

 

PERFORMANCE STANDARDS:

• Researches billing compliance issues and makes recommendations for changes to ensure appropriate charges for patient and hospital.
• Monitors facility inventory database to ensure appropriate coding and charging
• Works with other departments, to identify and troubleshoot patient charges for accuracy and appropriateness
• Enters daily manual charges accurately and in a timely manner
• Monitors reports for accuracy and reconciles any discrepancies
• Processes interdepartmental and clinic charges

 

6.            Maintains lab databases, regulatory records and reporting as assigned.

 

PERFORMANCE STANDARDS:

• Works with management to maintain lab records according to regulatory and/or legal guidelines, in an easy to retrieve manner, reviews for discrepancies
• Archives regulatory required logs, reports, and other required documentation accurately and within established timeframes and generates reports as required
• Generates reports as required/requested by lab management
• Performs general accounting/bookkeeping duties as required to complete job duties

 

1. Demonstrates effectiveness in monitoring the daily activities of the department.

 

PERFORMANCE STANDARDS:

• Ensures that standards of performance are administered daily
• Communicates policy interpretation to staff
• Communicates effectively and expresses information clearly to staff
• Maintains required records, reports and statistics as required
• Analyzes operational data and adjusts as necessary to provide adequate, economical service.

 

1. Performs high-level administrative duties for assigned area.

PERFORMANCE STANDARDS:

• Organizes and prepares complex documents requiring high-level knowledge of office technology and multiple software applications.
• Demonstrates fluency with all standardized formats utilized in correspondence, manuals, proposals, etc., possessing a clear comprehension and demonstrated capability to design and layout forms.
• Determines most appropriate software program for processing.
• Consistently proofs work for completeness and accuracy.
• Assists Medical Director and management team by scheduling appointments and meetings, developing travel itineraries, and coordinating related administrative activities.
• Arranges and schedules appointments, including interviewing callers and making proper referrals.
• Consistently reviews and prioritizes all incoming mail and material, checks and compares with previous material or other data, and brings to the attention of the executive(s) significant items, changes, errors or omissions.
• Organizes, establishes and maintains accurate record-keeping systems for correspondence, documents, materials, and other records.

 

 

1. Receives telephone calls and resolves routine and complex inquiries.

            PERFORMANCE STANDARDS:

• Exercises independent judgment in selecting and interpreting information, handling deviations from standard methods, and resolving difficulties.
• Demonstrates initiative in resolving non-routine situations requiring specialized knowledge or judgment.
• Facilitates communication with the pathology & laboratory management team by assessing the urgency of situations and determining appropriate action.

 

 

1. Coordinates and manages the billing and results reporting functions of the pathology/laboratory services department.

PERFORMANCE STANDARDS:

• Facilitates development, implementation and oversight of an integrated billing system that meets regulatory guidelines and requirements.
• Collaborates with GHS Internal Audit/Compliance department to develop and implement audit and quality control protocols to assure compliance with billing relations.
• Coordinates all results reporting to physicians and physicians' offices, ensuring promptness and accuracy.

 

 

1. Performs all other duties as assigned.

 

     

 

EXPERIENCE REQUIREMENTS

2 years' experience in a clinical setting required and 2 years of billing experience preferred.

 

 

EDUCATIONAL REQUIREMENTS

High School Diploma required, Associates Degree preferred

 

 

SPECIAL SKILL, LICENSE AND KNOWLEDGE REQUIREMENTS

Demonstrated critical thinking skills/computer knowledge.  Performs job as defined in the department's scope of service.  Able to handle numerous tasks simultaneously.  Excellent organizational skills.  Able to perform assigned duties in a timely manner with minimal supervision.

                                               

 

HIPAA REQUIREMENTS:

Maintains knowledge of and adherence to all applicable HIPAA regulations appropriate to Job Position including but not limited to:  Paper medical records with limit to job functions, electronic GHIN without limitation to job functions, patient demographics, lab results, patient information related to surgery or appointment schedules, patient related complaints, and/or information related to patient location.

 

 

SAFETY REQUIREMENTS:

Maintains knowledge of and adherence to all applicable safety practices appropriate to Job Position including but not limited to: Incident reporting, handling of wastes, sharps and linen, PPE, exposure control plans, hand washing, environment of care, patient identification, receives orders for patients, and collects blood samples.

 

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