Certified Medical Assistant (CMA) Access & Authorizations - Cancer Center (Days) (PRN)

Responsible for rendering clinical care within the medical practice in support of and as directed by the physician and or Radiation Oncology Nurse. Will also have general responsibilities to assist in the day to day operation of this office to ensure quality patient care. Responsible for some day-to-day operations and scheduling of a medical practice. Includes but is not limited to the scheduling of appointments, preparing reports, managing third party payer information and other administrative utilization information, ensuring excellent customer service for every patient. Assists with answering telephone, registering new patients, scheduling appointments, and completing prior authorizations for treatment. Able to multi-task while maintaining a high level of customer service and accuracy.

Required Knowledge & Skills

Education: Technical or Vocational school plus up to 2 years specialty training

Experience: Two years of related experience. Requires working knowledge of specialized practices, equipment, and procedures.

Licenses and Certifications

• CERTIFIED MEDICAL ASSISTANT

• HEALTHCARE PROVIDER (CPR)

Qualifications

• Must be certified as a Medical Assistant by the AAMA or a Registered Medical Assistant by the AMT. We will accept certification from NCCT and NHA. MA or nursing school may be used as part of the experience required.

• Must possess the sense of discipline to work in accordance with accepted clinical standards.

• Must possess the cognitive ability to understand patient's medical records, physician's orders and medical orders to be communicated to patient, hospital, and or other physician.

• Must be capable of dealing tactfully and effectively with patients, family members, other employees, and physicians.

• Must be able to schedule x-rays, scans, new referrals and follow-up appointments.

• NOTE: BLS within 90 days

• Working knowledge of RO ICD-9 and CPT coding required. Requires experience in physician practice coding.

• Two years of previous prior authorization experience.

• Exhibits exceptional communication skills.

• Data entry experience preferred. Must utilize multiple practice software systems.

• Detail oriented.

• Ability to work closely with others and function as a team member.

• Ability to analyze data and form recommendations.

• Proficient in various software within Microsoft Office including Outlook, Word, Excel, etc.

Statement Of Employment Philosophy

Being a part of Tanner Health System is more than a job, it is a promise we make to treat every patient with exceptional service every time they walk through our doors. Service excellence is the foundation of our organizational culture and the expectations we all set for each other, our patients, physicians and our community. All employees agree to abide by a set of service standards. These standards are the promise we make to provide the best care possible, and represent our beliefs, values and who we strive to become. We each commit to making Tanner Health System a great place for our employees to work, for patients to receive care and for physicians to practice medicine.

Functions

Area of Responsibilities

• Patient Care - Demonstrate competency in patient care. Maintain patient's safe passage in and out of the clinic, and ancillary services. Request and gather records for new patients prior to their first visit. Review present medications, allergy history, chief complaint, and brief interrogation of complaint. Update medication list and current problem list. Obtain past medical and surgical history, family history, social history, and vital signs. Be able to perform physical assessments on patients independently. Prepare and assist patients for examination, treatment, or procedure by medical staff. Monitoring of patient during examination or procedure. Act as a liaison between provider and patient. Explain medications, side effects, treatments, diets, diseases, and disease processes. Communicate with patients and or family members over the telephone to provide test results when directed by the Radiation Oncologist. Confirm and schedule appointments, answer questions and respond to messages in a timely manner and provide clear documentation of this communication in the patient's record. Call in or e-prescribe prescriptions to pharmacy when directed by the Radiation Oncologist. Maintain patient confidentiality. Complete FMLA and Cancer Policy forms for Cancer Patients and their families. Up to date on Meaningful Use documentation in the EMR.

• Teamwork -Works well with others and functions as a team player. Offers ideas and solutions for issues that affect the team and work area. Stocks and orders supplies as needed. Provide back up for the Radiation Oncology Nurse when she is busy or is off. Provide back up for the front desk as needed. Assist in other areas of the office as necessary. Answer phone.

• Safety -Maintains working knowledge of medical equipment and removes faulty equipment from use as necessary. Participates in safety programs.

• Development -Maintain and update level of skill for pertinent medical assistant duties. Participate in continuing education. Participate in the development of new programs (ex: Process Improvement, Quality Initiatives).

• Customer Service -Participates in patient satisfaction initiatives. Demonstrates excellent customer service skills. Communicates effectively with patients and management regarding service recovery opportunities. Works together with other team members to achieve Office and System customer service goals.

• Verifies insurance coverage and obtains prior authorization for all patients in radiation oncology. Notes authorization number in journal and Carepath in Aria.

• Creates estimates within Epic and Communicates financial responsibility for treatment to the patient.

• Creates billing referral within Epic to attach the prior authorization number to the patient's claim for proper billing.

• Transcribes orders to complete precertification process.

• Responsible for denied pre-certifications. Handles appeals and scheduling of peer to peers for authorization denials.

• Serves as back-up receptionist. Responsible for accurately updating patient demographics and insurance(s) at time of check-in, answers phones, patient check-in, scheduling consults, creating new health account records (HAR) in Epic, verifying insurance in Epic matches insurance that was authorized in Aria, creating new patient charts, appointment confirmations, scanning, and a multitude of other miscellaneous task.

• Maintains a working knowledge of department and facility policies and procedures. Displays independent reasoning skills for problem resolution as required with the scope of job assignments.

• Maintains strict confidentiality.

• May be required to assist with any other duties within the clinic appropriate to training and based on clinic needs.

Compliance Statement

• Employee performs within the prescribed limits of Tanner Health System's Ethics and Compliance program. Is responsible to detect, observe, and report compliance variances to their immediate supervisor, the Compliance Officer, or the Hotline.

Required Knowledge & Skills

Education: Technical or Vocational school plus up to 2 years specialty training

Experience: Two years of related experience. Requires working knowledge of specialized practices, equipment, and procedures.

Licenses and Certifications

• CERTIFIED MEDICAL ASSISTANT

• HEALTHCARE PROVIDER (CPR)

Qualifications

• Must be certified as a Medical Assistant by the AAMA or a Registered Medical Assistant by the AMT. We will accept certification from NCCT and NHA. MA or nursing school may be used as part of the experience required.

• Must possess the sense of discipline to work in accordance with accepted clinical standards.

• Must possess the cognitive ability to understand patient's medical records, physician's orders and medical orders to be communicated to patient, hospital, and or other physician.

• Must be capable of dealing tactfully and effectively with patients, family members, other employees, and physicians.

• Must be able to schedule x-rays, scans, new referrals and follow-up appointments.

• NOTE: BLS within 90 days

• Working knowledge of RO ICD-9 and CPT coding required. Requires experience in physician practice coding.

• Two years of previous prior authorization experience.

• Exhibits exceptional communication skills.

• Data entry experience preferred. Must utilize multiple practice software systems.

• Detail oriented.

• Ability to work closely with others and function as a team member.

• Ability to analyze data and form recommendations.

• Proficient in various software within Microsoft Office including Outlook, Word, Excel, etc.

Definitions

• Responsible for rendering clinical care within the medical practice in support of and as directed by the physician and or Radiation Oncology Nurse. Will also have general responsibilities to assist in the day to day operation of this office to ensure quality patient care

• Responsible for some day-to-day operations and scheduling of a medical practice. Includes but is not limited to the scheduling of appointments, preparing reports, managing third party payer information and other administrative utilization information, ensuring excellent customer service for every patient. Assists with answering telephone, registering new patients, scheduling appointments, and completing prior authorizations for treatment. Able to multi-task while maintaining a high level of customer service and accuracy.

Position Responsibilities

Contact with Others: Requires frequent contact with many persons at different levels inside and outside of the organization to carry out organization policies and programs and obtain willing acceptance, consent, or action.

Effect of Error: Probable errors may be serious and involve losses such as improper costs, overpayment, waste of material, damage to equipment, and delay in processing work. Effect usually confined within the organization. Most of work not subject to direct verification or check. Regularly works with some confidential data such as account, salaries, patient medical records, which if disclosed might have adverse internal or external effects.

People Management Responsibilities

Supervisory Responsibility: Exercises no supervision, work direction, or instruction of other employees or students

Work Environment/Physical Effort

Mental Demands: Work involves a variety of problems in a general field, some of which are complex. Involves some independent judgment to decide what to do to assemble facts, determine variations from standard procedures, or plan other action to be taken to meet general objectives.

Working Conditions: Minor - Occasionally involved in exposure to dirt, odors, noise, or some work is performed with exposure to temperature/weather extremes/occupational risk and probability of coming into contact with blood borne pathogens, other potentially infectious diseases, or biomedical/bio-hazardous materials.

Working Conditions Aspects for Immunizations

Performs tasks involving contact with blood, blood-contaminated body fluids, other body fluids, or sharps (needles): No

Directly works with Patients less than 12 months of age: No

Physical Effort: Minor physical effort - Job requires person to stand and/or walk frequently. Lifts, carries, or uses lightweight (1 to 25 lbs.) materials or equipment less than half of the day. Works in reaching or strained position intermittently. Office or laboratory work requires close visual effort less than half of day. Office or Laboratory work with concentration on a monotonous, repetitious procedure or skill most of day, where speed and accuracy are essential.

Physical Aspects

Bending: Frequent = 34% - 66% of the time

Typing: Constant = 67% - 100% of the time.

Manual Dexterity - picking, pinching with fingers etc.: Constant = 67% - 100% of the time.

Feeling (Touch) - determining temperature, texture, by touching: Occasional = 1% - 33% of the time

Hearing: Constant = 67% - 100% of the time.

Reaching - above shoulder: Constant = 67% - 100% of the time.

Reaching - below shoulder: Constant = 67% - 100% of the time.

Visual: Constant = 67% - 100% of the time.

Color Vision: Frequent = 34% - 66% of the time

Speaking: Constant = 67% - 100% of the time.

Standing: Frequent = 34% - 66% of the time

Balancing: Frequent = 34% - 66% of the time

Walking: Constant = 67% - 100% of the time.

Crawling: Not required

Running - in response to an emergency: Occasional = 1% - 33% of the time

Lifting up to 25 lbs.: Occasional = 1% - 33% of the time

Lifting 25 to 60 lbs.: Occasional = 1% - 33% of the time

Lifting over 60 lbs.: Occasional = 1% - 33% of the time

Handling - seizing, holding, grasping: Constant = 67% - 100% of the time.

Carrying: Frequent = 34% - 66% of the time

Climbing: Occasional = 1% - 33% of the time

Kneeling: Occasional = 1% - 33% of the time

Squatting: Occasional = 1% - 33% of the time

Tasting: Not required

Smelling: Not required

Driving - Utility vehicles such as golf carts, Gators, ATV, riding lawnmowers, skid steer, aerial lift: Not required

Driving - Class C vehicles: Not required

Driving - CDL class vehicles: Not required

N95 Respirator usage (PPE): Occasional = 1% - 33% of the time

Hazmat suit usage (PPE): Occasional = 1% - 33% of the time

Pushing/Pulling - up to 25 lbs.: Occasional = 1% - 33% of the time

Pushing/Pulling - 25 to 60 lbs.: Occasional = 1% - 33% of the time

Pushing/Pulling - over 60 lbs. : Occasional = 1% - 33% of the time