Pre-Services Specialist - Carmel-by-the-Sea, United States - US Radiology Specialists

Description

SUMMARY

The person in the position of Practice Manager must be able to perform the duties described within as well as to meet the company's qualifications regarding education, experience, patient service, attitude, language skills, meet physical requirements, possess mathematical and computer skills.

He/she must be able to read and write and to use logical reasoning ability as well as to be able to follow the direction of upper management.

The role of the Practice Manager is also one of Practice Administrator Designee where this individual acts as the Practice Administrator in the event the appointed Practice Administrator cannot be present.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.
Coordinate the daily operations of the practice
Establish appropriate staffing levels for the practice
Manage front and back office staff, including ancillary personnel
Schedule front and back office staff, optimizing clinic coverage
Verify and approve time clock for staff
Interview, hire, train, counsel, development performance improvement plans, conduct annual performance reviews, and disciplinary action as needed
Oversee orientation and ensure employees receive adequate training and ongoing education
Provide ongoing employee feedback of job performance
Provide positive feedback as well as constructive criticism
Establish and maintain a high level of employee engagement and morale
Promote teamwork and empower teams and individuals to meet their potential
Support quality and efficiency improvement efforts with a primary focus on MMG's priority initiatives
Develop personal education to be proactive in meeting the future needs of the practice
Demonstrate a positive attitude toward all patients and customers
Project positive, professional image
Maintain a high degree of knowledge of the policies and procedures of the practice
Must be able to learn, apply, and teach a variety of rules, regulations, policies, and procedures applicable to the ever changing healthcare environment
Responsible for maintaining OSHA logs and reporting workers compensation information to upper level management
Maintain a working knowledge of CPT, HCPCS, ICD-10 and HCC coding

Monitor and report on the administrative and clinical components related to regulatory payment systems such as MACRA, MIPS, HCC, etc.

Maintain strict control of internal cash handling procedures
Monitor patient experience scores and develop action plans for improving
Provide information and assistance to internal and external patients in a helpful, friendly manner
Resolve patient complaints with priority and answer questions regarding policies and procedures
Oversee the purchasing functions of the practice
Review, approve and code all invoices for payment
Maintain monthly office supply inventory, not in excess
Provide IT assistance and EMR support
Ensure office equipment is in working order
Organize meetings and education activities for doctors and staff, as necessary
Ensure general cleanliness and neatness of the practice
Maintain provider schedules including the on- call schedule
Consult with Upper Level Management regarding any problems or concerns, and assist in implementing organizational changes
Maintain compliance with contracted insurance carriers through auditing of clinical records and on-site visits
Monitor monthly operation reports and provide explanation of variances
Implement and monitor established workflows surrounding quality metrics, specifically relating to at-risk insurance contracts such as Aspire and Central California Alliance for Health
Monitor the coordination of care for individual patients by verifying the completion of the referral process through to receiving test and referral results
Apply the principles of comprehensive, community- based, patient centered, developmentally appropriate, and culturally and linguistically appropriate care coordination
Monitor and develop referral sources to improve the timeliness in care coordination
Train staff and support effective communication skills with vulnerable patient populations
Vulnerable populations are patients who are made vulnerable due to their:
Financial circumstances
Place of residence
Health
Age
Personal characteristics
Functional or developmental status
Ability to communicate effectively
Presence of chronic illness or disability
Train staff to maintain concise documentation in patients' electronic medical records
Ensure job roles and responsibilities emphasize team-based approach to care and support each member of the team being trained to meet the highest level of function
Knowledge of the care management process
Foster and adhere to team-based approach in patient care
Train staff to follow evidence-based approaches to self-management support such as patient coaching and motivational interviewing
Engage in population management activities to proactively address the needs of Montage Medical Group's patients and family members
Support the physicians and staff in assessing and managing the health needs of a patient population such as defined groups of patients:
Patients with specific clinical conditions such as diabetes, hypertension, chronic obstructive pulmonary disease, obesity, etc.
Patients overdue for preventive screenings such as cervical cancer screening, breast cancer screening, and colorectal cancer screening.
Proficient in all NCQA standards and guidelines for patient-centered medical home level three recognition (primary care practices only)
Conduct monthly Patient Centered Medical Home quality control audits (primary care practices only)
Conduct mandatory staff meetings and participate in huddles
Act as a primary contact point, advocate, and source of information for patients and community partners who help treat them
Other duties as assigned by senior management


MONTAGE VALUES
Employees of Montage Medical Group are expected to uphold the Montage Values and Service Standards.

Montage Medical Group employees find joy in caring for those we service, are dedicated to coordinating care across all settings, take ownership, collaborate to deliver the highest quality care and are entrusted to serve our community with respect.

QUALIFICATIONS
For the employee to execute this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE

The employee performing this position is expected to hold a High School diploma and have at least two years Medical (or related) Office Management and supervising experience (e.g., management in a health care setting, customer service, etc.) and/or training; or equivalent combination of education and experience.

Bachelors Degree, PCMH CCE and CPPM is required. S/he is expected to have some experience with medical terminology and understanding of medical insurance process.

S/he must be able to understand or quickly learn about the differences between and among patients with private insurance, Medicare, Medicare Advantage, Workers' Compensation and self-paying patients, etc.

The employee performing this position is expected to respond courteously, sympathetically and maturely to patient needs.

S/he must be detail oriented, well organized and computer literate (i.e., be familiar with a multiline phone system, PC and basic software, such as Microsoft Windows, Excel, Microsoft Word, etc.).

The employee must become a superuser on the practice's electronic medical record, Epic.

The employee performing this position is expected to be able to work under pressure and in stressful situations and must be able to work quickly when business conditions warrant.

APPEARANCE

The employee performing this position is expected to be neat and professional in appearance regarding clothing, hair, make-up and personal hygiene.

This position requires the employee to wear professional office attire.

PATIENT SERVICE, ATTITUDE AND LANGUAGE SKILLS

The employee performing this position is expected to have superior patient service, speaking skills and a professional attitude. One of Montage Medical Group's core values is we are a "Patient-Centered" practice.

High patient satisfaction and whole-person care are of critical importance and all employees must strive to achieve 100% patient satisfaction and quality outcomes for all patients.

All communications to co-workers, patients and clients must be courteous (e.g., "Mr. Smith, the Medical Assistant will show you to one of the exam rooms now.") The employee performing this position is expected to be able to speak clearly and effectively communicate with patients and co-workers. The employee must respect, understand and observe the importance of patient confidentiality. He/she is expected to abide by the company's HIPAA privacy policy.


MATHEMATICALAND FINANCIAL SKILLS

The employee performing this position is expected to have the ability to add, subtract, multiply, and divide, using whole numbers, common fractions, and decimals.

READING AND WRITING SKILLS

The employee performing this position is expected to be able to compile information and to be able to put information into a legible, hand-written format such as composing a hand-written note and/or to put into word processing on a computer.

S/he must have the ability to read and comprehend written documentation at a minimum of a High School level and possess the ability to read medical letters, reports and results at a basic level.

S/he must be able to interpret documents such as, safety rules, operating and maintenance instructions, and procedure manuals.

The employee performing this position is expected to possess the ability to write routine notes, e-mail (and Epic InBasket) messages, reports and correspondence using proper grammar and spelling.

COMPUTER AND BUSINESS EQUIPMENT SKILLS

The employee performing this position is expected to possess the ability to use effectively and efficiently a computer and related business and medical software.

S/he must be able to use typical business equipment, such as computer, fax machine, photocopier, adding machine, business telephone, voicemail, and e-mail.

Errors are expected to be kept to a minimum.


REASONING ABILITY
The employee performing this position is expected to possess the ability to apply

common sense

understanding to carry out instructions furnished in written, oral, or diagram form. S/he must be able to deal with problems involving several concrete variables in standardized situations.

S/he must be able to ask questions when unsure of any portion of the requirements of the position or job duties.

PHYSICAL DEMANDS

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.

While performing the duties of this job, the employee is regularly required to sit, stand and walk; use hands to finger, handle, or feel; reach with hands and arms; and talk or hear.

The employee is required to stand; walk; climb or balance; and stoop, kneel, crouch, or crawl.

The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds.

Specific vision abilities required by this job include close vision, color vision, and ability to adjust focus.


WORK 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.

While performing the duty of this job, the employee is occasionally exposed to moving mechanical parts (medical and office equipment), risk of working with blood borne pathogens, and risk of radiation (from office equipment such as computer monitors).

The noise level in the work environment is usually moderate. This environment is stressful and high pressure.

Individuals must enjoy working in such environments and be willing to adapt the pace of their work and output to the patient volumes and tasks of the office.

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