Administrative Support Medical

SCOPE OF POSITION: 
Responsible for the facilitation, coordination, and administrative support of review determinations. Coordinate aspects of medical records requests, receipt, tracking, and filing. May prepare review notices as assigned or directed. Maintains file control procedures in accordance with AFMC policy and State and Federal guidelines. Collaborate with medical and professional staff to accomplish goals within designated time frames. Support the organization’s mission, vision, and values by exhibiting the following behaviors: Honesty, Excellence, Accountability, Respect and Teamwork.

ESSENTIAL JOB FUNCTIONS:

1. Refer cases that require clarification or additional rational to the appropriate department Supervisor, Manager, Director, or the Associate Medical Director.
2. May be responsible for initial screening of medical records submitted for authorization of service, limited to the following tasks:
   1. Performance of review of service request for completeness of information; 
   2. Collection and transfer of non-clinical data; 
   3. Obtaining structured clinical data; and 
   4. Other review related activities that do not require evaluation or interpretation of clinical information.
   5. Seek direction from Clinical Services Specialist, Supervisor, Manager or Director for any clinical related questions or issues during the screening process. 
3. Proofread and coordinate all outgoing correspondence, memos, forms, reports, etc. for accuracy and distribute.
4. Scan, organize, file, maintain and track medical records, departmental records, correspondence, forms, etc. 
5. Receive and distribute all correspondence including mail, fax, memos, reports, and e-mail. Maintain contact lists to include addresses, phone numbers and e-mail addresses.
6. Answer incoming calls and route to the proper person. Answer questions and take messages when needed.
   1. Upon request, verbally informs patients, facility personnel, the attending physician and other ordering providers, and health professionals on how to obtain utilization management requirements and procedures.
   2. May inform callers how to find a list of procedure codes that do not require pre-certification
   3. Refers all callers with clinical related questions or concerns to an appropriate clinical staff member
7. Review, verify and edit the work produced by other staff members as directed.
8. Serve as a back up to other team members as assigned or requested.
9. Assist in training new team members.
10. Perform data entry and prepare reports of review activity. 
11. Adhere to format, content, and style guidelines, giving consideration to usability and ensuring accuracy, consistency, and quality.
12. Follow AFMC, state and federal protocols regarding data confidentiality/security and HIPAA compliance.
13. Communicate needs and requests to other team members as appropriate.
14. Additional duties as assigned.

KNOWLEDGE, SKILLS, AND ABILITIES:

• Intermediate skill level with MS Office (Excel, Word, PowerPoint, and Outlook).
• Type 40 wpm.
• Good command of the English language and knowledge of punctuation, grammar and spelling are required.
• Ability to maintain confidentiality.
• Strong oral and written communication skills.
• Customer service.
• Ability to meet deadlines.
• Attention to detail.
• Flexibility.
• Medical terminology.
• Ability to work collaboratively and independently to achieve stated goals.
• Initiative.
• Ability to relate professionally and positively with staff, business partners, customers, constituents, recipients, and the public.
• Ability to multitask.
• Ability to prioritize.
• Strong organizational skills.
• Professionalism.
• Time management skills.

Physical and Sensory Requirements (With or Without the Aid of Mechanical Devices):
Mobility, reaching, bending, lifting, grasping, ability to read and write, ability to communicate with personnel, ability to remain calm under stress. Must be able to lift and transport 25 pounds. Must be capable of performing the essential functions of this job, with or without reasonable accommodations.

EDUCATION:
Required: High School Diploma
Desirable: Associate’s degree or additional education in business

EXPERIENCE:
Required: Two (2) years administrative experience
Desirable: Experience in healthcare administrative setting. 

INTERNET REQUIREMENTS:
Reliable, high-speed wireless internet service (Wi-Fi)