Prior Authorization and Medical Records Coordinator- Outpatient Behavioral Health

Job Responsibilities

• Demonstrates proficiency in the rooming process for adult and/or pediatric primary care including: clinical procedures, immunizations, venipuncture, point of care testing, among others.
• Follows protocols and policies for scheduling, clinical procedures and appropriate use of medical equipment.
• Provides accurate/complete documentation of clinical calls and patient rooming info as well as order entry, pending prescriptions, noting current pharmacy, and enter edit workflows to result orders.
• Adds addresses patient messages (phone, mychart) in a timely manner and escalates patient issues as appropriate.

Job Requirements

• Graduate of an approved technical, professional, or vocational program in Healthcare; Healthcare clinical experience preferred.
• Physician practice or related field equivalent experience accepted in lieu of degree.
• Must be certified or registered medical assistant.
• Maintain this certification and registration status.
• Registered Medical Assistant (RMA), through AMT, NCCT, or NHA, or certified Medical Assistant (CAN) by AAMA, and Cardiopulmonary Resuscitation (CPR).
• Medical office flow, especially the clerical/front office tasks.
• Ability to make quick decisions based on well thought out consequences/results.
• Knowledge of EMR, practice management software and medical coding/billing strongly encouraged.

Job Overview

This position provides both direct patient care in a primary care office and works with care delivery providers to identify gaps in care, contacts patients to schedule required care, and provides referral follow up.

Job Requirements

• Certified or registered medical assistant.
• Strong skills in clinical care, customer service, communication, and teamwork.
• Understands the needs of the organization and supports the mission, values, and management of TriHealth Physician Practices.

Job Responsibilities

• Demonstrates proficiency in the rooming process for adult and/or pediatric primary care including: clinical procedures, immunizations, venipuncture, point of care testing, among others.
• Follows protocols and policies for scheduling, clinical procedures and appropriate use of medical equipment.
• Provides accurate/complete documentation of clinical calls and patient rooming info as well as order entry, pending prescriptions, noting current pharmacy, and enter edit workflows to result orders.
• Adds addresses patient messages (phone, mychart) in a timely manner and escalates patient issues as appropriate.
• Maintains knowledge of population health, and embraces the philosophies of wellness, prevention and chronic disease management.
• Participates in tactics to close gaps in care. Includes pre-visit planning, participation in daily huddles, and informing physicians of any potential barriers to care identified.
• Identifies and communicates with providers regarding patient wellness, chronic diseases, utilization, and care gaps.
• Attends continued education training and education such as Lunch and Learns and other opportunities.
• Participates in the longitudinal care continuum of patients. This includes collaborating with wrap-around services such as behavioral health, complex care nursing, social workers, community health workers, among others.
• Provides basic community resources to patients with social determinants of health.
• Supports and provides education and patient coaching of both wellness and chronic disease management.

Working Conditions

• Climbing - Occasionally
• Concentrating - Consistently
• Hearing: Conversation - Frequently
• Interpersonal Communication - Consistently
• Kneeling - Occasionally
• Lifting
• Lifting 50+ Lbs - Occasionally
• Lifting 11-50 Lbs - Rarely
• Pulling - Occasionally
• Pushing - Occasionally
• Reaching - Consistently
• Reading - Consistently
• Sitting - Consistently
• Standing - Frequently
• Stooping - Occasionally
• Using Hands - Consistently
• Color Vision - Consistently
• Walking - Consistently

TriHealth SERVE Standards and ALWAYS Behaviors

• Welcome everyone by making eye contact, greeting with a smile, and saying "hello".
• Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist.
• Refrain from using cell phones for personal reasons in public spaces or patient care areas.
• Excel: Always… Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met.
• Offer patients and guests priority when waiting (lines, elevators).
• Work on improving quality, safety, and service.
• Respect: Always… Respect cultural and spiritual differences and honor individual preferences.
• Respect everyone’s opinion and contribution, regardless of title/role.
• Speak positively about my team members and other departments in front of patients and guests.
• Value: Always… Value the time of others by striving to be on time, prepared and actively participating.
• Pick up trash, ensuring the physical environment is clean and safe.
• Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste.
• Engage: Always… Acknowledge wins and frequently thank team members and others for contributions.
• Show courtesy and compassion with customers, team members and the community.