Location: Bethesda, MD
Company: STG International
for exam and administrative fulfillment activities. Performs quality assurance (QA) on all incoming exams to ensure that all services have been performed according to agency medical requirements and request any missing components from the OHC or PPN where the exam was performed.
Creates records within the FOH database and enters tracking dates. Secondary duties could include: Scheduling of exams according to the agency IAA, sending of determinations to agencies via mail or electronically, and exam data entry. Clinical The Joint Commission (TJC) - Quality and Safety Participates in preparation for TJC accreditation, as requested. Use checklist created by the LE-S Program Manager to backss
exam quality and record quality indicators (e. g. check for missing items) as directed by the PM. Complete required training according to specified deadlines.
Attend all mandatory training for DE, AA and AMA roles. Demonstrate understanding of the content of the LE-S Case Review Program Plan annually. Service Operations Process case review types according to the applicable case review SOPs within timeframes specified by the PM. Identify and report measures that can be taken to improve case processing efficiency to PM. Forward questions from CHS staff about the case management process (i. e. questions related to services, work order interpretation & billing) to the AMA. Schedule
examinations in OHCs and through the PPN according to SOP and within timeframes specified by the PM and based on agency agreements.
Contact FOH OHCs and Private Network Provider points of contact and use the private provider network portal to obtain missing exam and follow up items in timeframes designated by the PM per the current exam process SOP. Escalate missing exam items and other concerns that prevent case processing for > 14 days. Provide administrative and clerical support for case review processing. Maintain case review office files for assigned work as directed by supervisor and according to SOP. Ensure that exams are mailed/ emailed according to Interagency Agreement specifics and dates tracked.
Report all privacy and security breaches immediately according to FOH and HHS policy Assist the PM in orienting all levels of new AA case review staff. Works on agency agreements with other staff members as assigned by the Assistant Program manager Attend all case review team meetings Administrative (Business/Management)Procurement Alert PM or Assistant Program Manager regarding new business opportunities and customer requests to change requirements for existing business. Assist with implementing new case review business and changing requirements for existing business.
Cost Recovery Enter data to track exam fulfilment in current FOH database for exams that are received in the area office. Advise PM or AMA about billing discrepancies. Perform billing fulfilment for exams received in the area office per the billing fulfilment SOP. Demonstrate a complete understanding of the current database used for billing, RMO reviews and exam tracking staffing and reporting relationships. Staffing and Reporting Relationships Be on time to work, work all designated hours, request leave in timely fashion. Request leave according to specified timeframes.
Adhere to telework policy when permitted. Create a climate of trust, accountability, and professionalism. Understands 'chain of command' to report issues affecting productivity and morale. Identify and report problems to supervisor with hardware, telecommunications or other issues impacting duties. Technology Knowledgeable and proficient in IT systems, for database entry, tracking, other deliverables. Attends training on IT systems, both initially and with updates; asks for help when needed. Completes mandatory IT training by specified deadlines. Inform PM of IT and other equipment needs, particularly those that prevent completion of case processing within specified deadlines.
Strategy Customer Service Manage customer/agency complaints professionally and route to the appropriate AMA via email within 24 hours Advise AMA/Team any observations which may necessitate changes to Agreement no later than 48 hours after learning about the change. Respond to customer complaints, issues, and requests regarding FOH service within 24 hours. Follow outstanding issues to resolution in a timely manner. Escalate issues as appropriate and directed by the PM.
Complete assigned tasks to ensure that all exams including priority exams, exams that carry a turnaround penalty, and RMO reviews meets FOH and agency turnaround requirements per the agency agreement. Forward issues requiring RMO attention to Agency-specific AMA Metrics Generate customer specific reports in current FOH database as required by the agency agreement. Monitor tracking metrics. Suggest process improvements to and implement process changes as directed by case review team supervisors to ensure that quality and efficiency goals for the case review team are met. Meet weekly target productivity goals for case creation and case closure.
Complete all required tracking fields within the database systems. Required Skills Minimum Requirements/Knowledge/Skills: Must possess excellent oral and written communication skills. Must be able to accept assigned work and complete within expectations of timelines. Must demonstrate an understanding of medical terminology and a basic understanding of the clinical exam process. Seeks assistance and guidance from supervisors when needed. Proficient with MS Excel, Word, and Power Point Typing speed: 50 Required Experience Minimum Education Requirements/Certification/Licensure/Experience: High school diploma or equivalent with two years' experience working in a health care setting which required the use of medical terminology, such as experience in office front desk operations.
Demonstrated excellent interpersonal communication skills. STG International, Inc (STGi) is a workforce solutions company providing comprehensive healthcare delivery, Head Start and management consulting services and human capital solutions help our clients. Our services and solutions help our clients sustain and enhance their operations to better accomplish their mission.
STGi offers a competitive benefits package which includes Medical, Dental, Vision, 401k with company match and a generous PTO policy. STG International, Inc. is committed to hiring and retaining a diverse workforce. We are proud to be an Equal Opportunity/Affirmative Action Employer, making decisions without regard to race, color, religion, creed, interaction, interactionual orientation, gender identity, marital status, national origin, age, veteran status, disability, or any other protected class. Medical Corps - 60J, 60L, 61F, 61H, 61N, 61R,62B Medical Specialist Corps - 65B, 65C, 65D Nurse Corps - 66B,66H, 66P Medical Service Corps - 67G, 67J Medical CMF - 68A, 68B, 68E, 68F, 68G, 68J, 68Q, 68R, 68S, 68T, 68W, 68X, 68Y
Administrative/clerical jobs involve a range of office support and secretarial roles that are crucial to the smooth operation of any business or organization. These positions typically include tasks such as data entry, managing correspondence, scheduling appointments, answering phones, and maintaining files. Employees in these roles must be organized, proficient in various office software, possess strong communication skills, and be capable of multitasking. Key traits for success in administrative and clerical jobs include attention to detail, reliability, and the ability to work both independently and as part of a team. These roles often serve as the backbone of a company, ensuring efficient workflow and supporting other departments.
Administrative/clerical jobs involve a range of office support and secretarial roles that are crucial to the smooth operation of any business or organization. These positions typically include tasks such as data entry, managing correspondence, scheduling appointments, answering phones, and maintaining files. Employees in these roles must be organized, proficient in various office software, possess strong communication skills, and be capable of multitasking. Key traits for success in administrative and clerical jobs include attention to detail, reliability, and the ability to work both independently and as part of a team. These roles often serve as the backbone of a company, ensuring efficient workflow and supporting other departments.
Administrative/Clerical jobs refer to roles that primarily involve office support tasks such as data entry, phone handling, scheduling, filing, and assisting executives. Those in administrative and clerical positions are the organizational backbone of an office and are responsible for the seamless flow of information. They require strong organizational skills, attention to detail, and the ability to handle multiple tasks simultaneously. These roles often require competency in computer software, customer service, and communication. The work is typically performed in an office environment, providing the foundational support that keeps the daily operations of a business running smoothly.
Administrative and clerical jobs encompass a range of office-based roles that are essential for the smooth functioning of organizations. These positions often involve tasks such as data entry, managing correspondence, scheduling appointments, and maintaining records. Key features of administrative/clerical jobs include strong organizational skills, attention to detail, and proficiency in office software. Employees in this field are typically great communicators and are able to multitask effectively in a fast-paced environment. Though duties can be diverse, they all contribute to the administrative support structure of a business.
