Summary
Under direct supervision of the of providers will be responsible for ordering testing and referrals for ongoing care and treatment, tracking and monitoring the patient recall list, obtaining insurance authorizations for time sensitive testing, and maintaining appropriate documentation.
If applicable, works as the clinical navigator for patient education and counseling regarding all testing and procedures.
Performs specialist referrals included in the patient’s treatment plan.
Prepares and assembles materials regarding testing and procedures to be provided to the patients.
Also, performs administrative duties to ensure efficient services and working relationships with other MyMichigan Health departments as well as external departments.
Tracks tests results and communicates with the provider for follow up to the patient.
The expectations outlined in this job description may vary slightly depending on the practice in which you are assigned.
Responsibilities
- (30%)*Under the direction of the providers, orders testing and specialist referrals as outlined in the patient’s treatment plan.
- Schedules initial consultation, follow up appointments and testing.
- Obtains insurance authorizations as necessary. (30%)*Assist patients with education, counseling and navigation of the health system and terminology from point of testing through their courses of treatment.
- Counsel patients and families on their medical condition, individual plan of care, and use of prescribed treatment/medications.
- Coordinate patient care with other treatment team members.
- Possess an in-depth knowledge of the specialty, diagnoses, and disease processes treatment options.
- Coordinates and schedules appointments as appropriate.
- Monitors if patient is non-compliant with treatment plan and appointments. (20%)*Under the direction of the physician, conducts daily coordination with other specialists and departments to determine appropriate course for patient’s treatment plan. (10%)*Reviews patient file to pull necessary documentation for ongoing care and treatment.
- Tracks patient care throughout the course of the treatment plan outlined by the physicians.
- Prepares educational materials needed for patient consultation. (10%)*Pull imaging studies and other appropriate testing to review with Invasive Imaging department to determine what procedure(s) should be performed.
- Send clinical data to radiologist to assist in preparing patient protocols.
- OTHER DUTIES AND RESPONSIBILITIES: Follow up on EMR task list and work list items as appropriate.
- Maybe required to schedule surgeries and testing.
- Acts independently, using a high knowledge base of the specialty in order to performs decision making using discretion and judgment which requires critical thinking and communication skills, frequently in stressful situations.
- Obtains insurance authorizations for time sensitive testing and for ongoing care and treatment.
- Reviews insurance rejections or requests with patient, insurance biller and/or customer service representative.
- Under the direction of a provider order, is involved patient testing and care based on evolving and changing guidelines.
- Assists in maintaining a clean and safe environment for patients and co-workers.
- A minimum of 3 years in clinical experience in a health care facility or medical office and/or specialty practice.
- Knowledge of medical terminology.
- Maintains a high level of confidentiality and ensures patient’s rights in accordance with proper procedures and in compliance with HIPAA (Health Insurance Portability Accountability Act).
- Performs administrative duties, such as, organizes office, orders supplies, fills out insurance forms, creates correspondence, arranges hospital admission, answers the telephone, updates/files/scans information into patient’s medical records.
- Maintains a system for accurately recording, coding, and reporting patient conditions in the medical record.
- Participate in annual review for quality and completeness.
- Processes all diagnostic testing reports and verifies all provider Electronic Signature Authorizations are completed insuring copies are sent to referring physicians if needed.
- Faxes copies of reports and requested information as needed.
- Performs other related duties as assigned.
- MyMichigan Health is a technology driven organization and employees need to demonstrate competency in Microsoft® Windows.
- An employee may be required to participate in further learning opportunities offered by MyMichigan Health.
Certifications and Licensures
BLS - Basic Life Support Required Equivalent Experience - Within 3 months of hire or transfer MA CERT - Medical Assistant Required Equivalent Experience - In conjunction with high school diploma as required by Medicare and Medicaid Services (CMS) to be employed through MidMichigan Physicians Group all positions that require clinical access to the Electronic Medical Record, must possess one of the following active certification/licensure: Registered Medical Assistant (RMA) through American Medical Technologist (AMT) Certified Medical Assistant (CMA) through American Association of Medical Assistants (AAMA) OR equivalent Medical Assistant Credential such as (Certified Clinical Medical Assistant CCMA, etc.). Medical First Responder, Emergency Medical Tech Basic/Specialist, or Paramedic though the State of Michigan. Registered Radiologic Technologist through American Registry of Radiologic Technologists (ARRT) or (ARDMS) as an equivalent.
Required
Education
- High
- School
- Diploma or
- GED
- Comments: Prefer completion of an Associate’s Degree in a Healthcare Related field.
Other Information
Experience, training and skills
- Experience as normally acquired through working in oncology or general surgery practice. Knowledge of reading, writing, mathematical and computer skills.
- Physical/Mental
- Requirements
- AND
- TYPICAL
- WORKING
- CONDITIONS: Exposure to stressful situations, including those involving public contact, as well as, trauma, grief and death. Able to wear personal protective equipment that includes latex materials or appropriate substitute if required for your position. Is able to move freely about facility with or without an assisted device and must be able to perform the functions of the job as outlined in the job description. Overall vision and hearing is necessary with or without assisted device(s). Frequently required to sit/stand/walk for long periods of time. May require frequent postural changes such as stooping, kneeling or crouching. Some exposure to blood borne pathogens and other potentially infectious material. Must follow MyMichigan Health bloodborne pathogen and TB testing as required. Ability to handle multiple tasks, get along with others, work independently, regular and predictable attendance and ability to stay awake. Overall dexterity is required including handling, reaching, grasping, fingering and feeling. May require repetition of these movements on a regular to frequent basis.
- Physical
- Demand
- Level: Sedentary. Must be able to occasionally (0-33% of the workday) lift or carry 0-10 lbs.
Equivalent Experience and Other Comments (Education)
Other Comments
