Pacific Clinics

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Client Data Specialist

at Pacific Clinics

Posted: 10/10/2019
Job Reference #: *B06EFA40D4ED5561
Keywords: computer, system

Job Description

Requisition Number
19-0616

Post Date
8/26/2019

Title
Client Data Specialist

Type of Program
Administrative

Hours Per Week
37.50

Minimum Salary
$16.48

Bilingual Preferred
Spanish

City
Pasadena

State
CA

Description
Job Title: Client Data Specialist

POSITION SUMMARY

Primary responsibilities are to accurately maintain up-to-date client data in the Electronic Health Record (EHRS) and Payor systems for the purpose of processing claims in a timely manner. The Client Data Specialist verifies clients’ healthcare benefits and eligibility to determine the correct payor waterfall sequence for claim submission. The Client Data Specialist will establish and maintain relationships with the respective divisions to ensure timely submission of client data within the system.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Accurately and comprehensively maintains up-to-date client data in the Electronic Health Record (EHRS) and Payor systems for the purpose of processing claims in a timely manner.
• Processes client data to open/close the case within appropriate systems.
• Opens and closes cases in EHRS within 24 hours of receipt, and ensure Medi-Cal Eligibility documentation obtained during the intake process is scanned into the client record.
• Reviews and enters client data based on information provided by clinical team.
• Ensures correct pay sources are created, set-up and changes are completed, reviewed and submits client data to county systems as appropriate.
• Updates all client data information, monitors the consistency of client information between systems to ensure reimbursement of claims.
• Coordinates and processes void claim requests from clinical staff.
• Provides assistance to Support Services for the Financial Screening Process.
• Retrieves, reviews and enters Outcome Measures (OMA) into the county’s system.
• Reconciles the Outcomes Data Report with DMH Outcomes Measure Application system Provides audit support by reviewing client financial folders with client eligibility and client financial documents and provides financial audit support during agency reviews..
• Reconciles billing entries in all data systems and progress notes in the chart.
• Performs and maintain a Program Liaison, “relationship”, representing the department to other internal departments.
• Communicates with clinicians, case managers, psychiatrists and nurses regarding corrections on progress notes.
• Maintains an organized work area and follow Pacific Clinics standards.
• Provides backup support within the RCDA Team when requested.
• Attends appropriate site meetings, activities, and staff meetings upon request to provide input towards client data administration, billing procedures, program development and staff training.
• Interacts with other internal programs, clinical/support staff and external sources such as school or community personnel as applicable.
• Follows HIPAA policies.
• Performs all duties and work projects as assigned – by or before the specific due date agreed to with your manager.
• Reports to work on time and maintain reliable and regular attendance.
• Works in a multicultural team sensitive to the cultural and linguistic needs of the clients and families served.
• Models Pacific clinics’ approach, mission and core values in all communication and correspondence.
• Communicates effectively in a competent and diverse consumer population and promotes favorable interaction with managers, co-workers and others.
• Performs other duties as assigned.

QUALIFICATIONS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

ORGANIZATIONAL RELATIONSHIPS/INTERACTION:

Initiate and maintain professional interactions and communication with Clinic’s employees and/or others.

Maintain professional and effective working relationships, follow all policies and procedures and approaches challenges with a proactive and positive attitude. Develop strong, trusted relationships with colleagues and customers.

Maintain the confidentiality of all business documents and correspondence.


Requirements
EDUCATION and/or EXPERIENCE/POSITION REQUIREMENTS

• Minimum of a High School Diploma or G.E.D with (3) three years direct healthcare billing experience
• Two years previous data entry work experience in healthcare EHRS billing
• Knowledge of the healthcare service claiming workflow, preferably in Behavioral Healthcare using the Welligent EHRS
• Knowledge of the healthcare claim payors, and the payor waterfall, including third party payors preferably in Behavioral Healthcare
• Knowledge of an Electronic Health Record System (EHRS) used in Healthcare for billing clinical services preferred; preferably in Behavioral Healthcare
• Ability to use the Windows file system, as well as Microsoft Word, Outlook, Access, and Excel applications with moderate to intermediate proficiency
• Must possess a valid California driver's license and maintain an insurable driving record under the clinics' liability policy (if driving two or more times per week on company business) OR if driving is not required, demonstrated ability to use public transportation or other means to travel between sites, if requested.
• Ability to use a computer keyboard proficiently, above 35 wpm
• Ability to independently problem solve, as well as analyze and resolve complex issues related to billing.
• Ability to prioritize extremely time sensitive documentation submissions; must be flexible, organized, and conscious of these timelines
• Skilled in problem solving, multi-tasking, completing repetitive tasks with accuracy, follow standard procedures and guidelines to solve problems and obstacles.
• Skilled in being very detail and results oriented, approaching tasks methodically, following through on projects to achieve results, being organized and prioritizing competing deliverables.
• Excellent customer service skills.
• Excellent verbal & written communication.
• Ability to communicate effectively with a competent and diverse population and promote favorable interaction with managers, co-workers and others.
• Ability to adapt and be flexible in a rapidly changing environment, be patient, accountable, proactive, take initiative and be a team player and work effectively on a team.
• Ability and willingness to learn new topics, systems, and methods.
• Ability to work overtime during the weekdays and weekends (Saturday and/or Sunday) when requested, based on the clinics’ needs.

PHYSICAL DEMANDS:

While performing the duties of this job the employee is frequently required to stand or sit. The employee is required to use hands to produce records and/or documentation in manual or electronic format. The employee must regularly lift and/or move up to 5 pounds and occasionally move or lift up to 10 pounds.

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is occasionally exposed to moving mechanical parts and outside weather conditions. The noise level in the work environment is usually moderate. Local business travel is required.

SITE SPECIFICS:

A review of this description has excluded the marginal functions of the position that are incidental to job performance of the fundamental job duties. All duties and requirements are essential job functions.

This job description in no way states or implies that these are the only duties to be performed by this employee. The employee will be required to follow any other instructions and to perform any other duties requested by his or her Manager and/or Supervisor.