The Medical Assistant OP Ancillary works under the supervision of the RN Clinical Manager, RN, PA or MD. This position provides direct care for clinic patients as well as general duties to assist professional staff. May prepare patients for care, assist patients with limited mobility, as well as perform specific procedures with appropriate orientation and supervision. Responsible to follows all out patient ancillary and hospital policies and procedures. Responsible for insurance authorization and billing duties.
- Assists licensed personnel with patient care in the clinic setting including Collection of information such as vital signs, capillary blood glucose monitoring, O2 Sat, suture removal, dressing, splinting, wound measurement, wound photography and debridement.
- Performs diagnostic testing such as TCOM, ABI and Doppler, reports results to MD and RN, makes certain forms are complete and in medical record and billing completed for procedure.
- Tracks Cellular Tissue ordering and compliance with Payor requirements, documentation of Product use in chart, Tissue Log, and billing forms. Notifies RN and MD of product availability or expiration status.
- Performs or assists clerical staff in preparation for clinic, including pulling charts and preparation of chart forms and worksheets, labeling and filing, data entry, billing, answering phones, and patient scheduling.
- Screens new patient intake information and collects patient history information from previous care sites for use in new patient encounters. Gathers and posts test results for RN and Physician review.
- Maintains an active role in orderliness and sanitation of clinic; keeping treatment rooms fully stocked; sterilization of instruments; maintaining equipment clean and functional reporting deviations to management.
- Keeps inventory of supply utilization and orders necessary supplies.
- Insurance Authorization Responsibilities
- Obtain Insurance Pre-Authorizations and referral numbers for test and procedures ordered by the clinic and follow insurance verification process.
- Obtain authorizations for out-patient testing/diagnostic scheduling .
- Obtains referral numbers/authorizations and does insurance verification for specific insurances through point of service devices .
- Contacts primary care physicians, referring physicians, employers and/or insurance companies to inform them of treatment for patients with managed care insurances.
- Tracks authorizations for visits and procedures and communicates with physicians and staff regarding need for further authorizations as well as need for clear documentation that supports the services delivered and appropriate billing.
Major Position Responsibilities:
- Provides the patient with care as directed by RN Clinical Manager, RN, PA or MD. The patient’s response to and the outcome of the care provided is observed and communicated.
- Routinely reports patient response to care and other clinical data to RNs in a timely fashion.
- Organizes and prioritizes work to provide patient care in a safe environment.
- Responds to needs for assistance and service in a timely and professional manner.
- Actively keeps patient and families informed of status of care and treatments per RN and/or MD.
- Participate in the care of patients and be accountable for working with a team of providers.
- Protects all patient rights, including confidentiality.
- Demonstrates consistent use of safety-related policies and procedures including OSHA Blood borne Pathogens Standard, Standard/Universal Precautions, body mechanics, biohazardous waste management, fire and disaster plans.
- Prioritizes work, keeping supervisors aware of progress and available time.
- Documents on forms clearly, legibly and uses only approved abbreviation.
- Flexible with staffing needs to the outpatient setting, physicians, patients and co-workers.
- Consistently demonstrates rapport even with difficult or demanding customers.
- Assumes active role in wound care by attendance at staff meetings, in-services and other wound care related activities. Reviews minutes when unable to attend.
- Insurance Authorization Responsibilities
Safety and Infection Control Responsibilities
- Utilizing safe procedures in infection control, exposure control, equipment, supplies, facility, emergency, safety, fire and disaster plans, adhering to guidelines or standards of practice in the community, the hospital and all current wound center policies and procedures.
- Adhering to guidelines or standards of practice in the community, associate hospital and all current wound center policies and procedures.
- Demonstrating consistent use of OSHA guidelines and Standard/Universal Precautions and proper body mechanics.
Qualifications: ESSENTIAL COMPETENCIES, KNOWLEDGE, & EXPERIENCE
- Minimum two (2) year prior experience in a nursing/medical setting required
- Experience with managed care and private insurance authorization preferred.
- Office skills such as word processing; database; and spreadsheet desirable.
- Able to complete a 2-person lift, wheelchair to exam table
- High School Diploma or equivalent required
- Successful Completion of CNA or Medical Assistant Program required
- Medical Assistant or CNA Certification, required within 6 months of hire