Medical Support Assistant at Entourage Consulting, LLC / America Jobs

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Medical Support Assistant

at Entourage Consulting, LLC in Minnesota

Medical Support Assistant
Place of Performance: Cass Lake, MN

General Description:
Medical Support Assistant shall determine patient eligibility for care under the Purchased/Referred Care Program.

Specific Tasks:
• Apply PRC rules and regulations on PRC Delivery Areas, geographical facility proximity, tribal membership, and residence.
• Determine patient eligibility as a prerequisite to the authorization of funds.
• Participate in the decision making process for the provision or denial of payment for services based upon eligibility criteria.
• Define alternate resources available to patients under the PRC Program and determines patient eligibility for Medicare, Medicaid, Vocational rehabilitation, V.A., private insurance or other third parties.
• Contact alternate resource agency or organization via telephone, correspondence or personal visit to insure maximum utilization.
• Conduct personal interviews with patient or family members to determine potential eligibility for alternate resources. Interview in-patients/outpatients to obtain pertinent current patient registration demographic information and enters/maintains in Practice Management and the RPMS Patient Registration system.
• Obtain, verify, and sequence insurance information for billing and maximum reimbursement from all alternate resources. Assure that all information is current and correct prior to billing for services. Identify the order of billing/coordination of benefits on reason for visit or clinic type. Obtain signatures for Medicare and private insurance patients.
• Identify patients whose health benefits are subject to prior approval to determine the extent of health care for both inpatient and outpatients. Explain the program to the beneficiaries, why Medicare, Medicaid and or private/commercial insurance will be billed for rendered services. Initiate all admitting forms to complete the admission with current patient data, including the RPMS patient registration sections utilizing hospital and other local resources. Patient Registration you must interview patients to obtain and process demographic insurance information, alternate resources, contract health services, and private or commercial insurance. Assist in completing patient registration forms and determines eligibility and tribal membership. Patient registration you interact with patients and utilizes automated systems.
• Must be flexible in order to undertake a variety of miscellaneous duties as assigned by the Supervisor. Adjust work assignments as needed to cover peak times, leave requests and vacancies. Prioritize work to ensure work is disseminated appropriately and notifies immediate supervisor when a backlog of 4 or more days occurs.
• Perform other duties as assigned.

Qualifications:
• Shall be a U.S. citizen.
• Shall be able to read, write, and speak English well enough and enunciate with sufficient clarity to effectively communicate with patients and other health care providers.
• Shall possess sufficient initiative, interpersonal relationship skills and social sensitivity such that you can relate to a variety of patients from diverse backgrounds.
• Shall be able to operate a personal computer utilizing Microsoft applications, such as Word, Excel, and efficiently utilize an Electronic Medical Record.
• Shall be able to type and have had experience using computers.

Knowledge:
• Knowledge of proper processing requirements including forms, authorization documents and standard correspondence.
• Knowledge of the various clinical systems, walk-ins and appointments to avoid unnecessary delay or confusion on the part of the patient.
• Knowledge of the patient registration function and requirements for obtaining necessary third party information.
• Knowledge of patient registration and ability to enter and update eligibility, demographic, contact, and insurance information into RPMS accurately.
• Knowledge of Privacy and confidentiality considerations.
• Skills in operating computers, scanner, copier machines and other standard office equipment.
Reference : Medical Support Assistant jobs

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