Clinical Operations Specialist
FEFA LLC
N/A
Job Details
Full-time
Full Job Description
FEFA LLC is seeking a Clinical Support Coordinator (CSC) who is responsible for assuring the quality of clinical service is maintained through evaluation of Compensation and Pension document requests and approving order requests. Determines the appropriate Disability Benefit Questionnaires (DBQ) to assign to specified health conditions identified during order request review. Accurate review of the claims file and correctly labeling relevant evidence ensures pertinent information is identified during claims file bookmarking, alerting Providers and allowing timely and accurate completion of the DBQs by the examiner. The CSC is responsible for timely work, positively affecting the life-cycle of the order. The CSC will collaborate with subject matter experts (SME), CSCII, Leads, and Supervisors to ensure completion of work aligns with established production and quality standards.
Key Responsibilities:
- Conduct accurate and timely review of records
- Evaluate and interpret order requests
- Quality set-up of order request to aid Provider in exam review
- Claims file review and identification of relevant evidence
- Quality claims file bookmarking to aid Provider in exam review
- Request clarification for errors and/or requests not meeting contractual requirements
- Identify trends of new or changing order items
- Participates in projects and team meetings
- Perform detailed work with a high degree of accuracy
- Maintains confidentiality of sensitive information
- Conduct task completion via automated workflow
Requirements
-
Completion of an accredited Medical Assistant program and current certification (CMA) from an accredited certifying body or Associate's or Bachelor's degree in a related field (e.g., Healthcare Administration, Medical Assisting). - Minimum 5 yrs experience in healthcare
- Must be able to type 40 WPM
- Knowledge of healthcare documentation to include medical, behavioral, and psychological terminology
- Excellent verbal and written communication skills including, strong telephone etiquette and interpersonal skills
- Ability to identify lab results and ancillary services
- Ability to interpret medical documentation
- Experience working in an Electronic Medical Record system
- Ability to work Monday - Friday / 9a - 6p CST
- Knowledge of healthcare documentation and terminology
- Ability to anticipate potential problems and explore solutions collaboratively
- Demonstrates a coachable mindset and ability to remain focused
- Proficiency in healthcare documentation and terminology
- Excellent written, verbal, and interpersonal communication skills
- Strong multitasking and teamwork skills
- Ability to perform detailed work with a high degree of accuracy
- Knowledge of CPT and ICD coding
- Experience with traumatic brain injuries, neuropsychological testing, or behavioral health
- Home health, Military or hospice care experience
- Technical (basic computer knowledge)
- Ability to type 40 WPM
Knowledge and previous use of:
- Browsers
- Chrome, Edge, etc
- Search engines
- Google, MSN, Yahoo etc
- SharePoint
Common keyboard/computer commands
- Copy
- Paste
- Insert
- Differentiation of right vs. left click
- Drag and Drop
Proficiency with Microsoft Suite
- Outlook
- OneNote
- WORD/Excel
- Teams
- Previous experience with an EMR/HER system
- Experience with a virtual learning platform
- MicroSoft Teams, Zoom, WebEx
- Screen sharing
- Ability to troubleshoot
Code of Conduct
- Dress Code: While this is a work from home option we do expect certain standards for attire
- Business casual please (tops and bottoms are required)
- Dependent care
- Alternate care is required for dependents
- Children should not be in the background or the same room
Distractions
- Minimize interruptions such as people, pets, personal cell phone
- Professional demeanor and use of company resources
- Adequate office space
- Closed and locked door are a requirement
Benefits
FEFA LLC is an equal-opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or on the basis of disability. We offer a competitive compensation package including a competitive salary, medical benefits, PTO, holiday pay and more.