POSITION REQUIREMENTS: High School Diploma required; Associates Degree preferred. Must have excellent organizational, customer service, and computer skills. Must have knowledge of Microsoft Office 2010 and Windows 7. Medical record experience preferred with emphasis on electronic records, or related discipline with a minimum of two years’ experience in program management or records management, or related field, equivalent applicable education, experience, and/or training.

SUMMARY: Maintain PACE participant records; respond to requests for medical records; assist with plan provider payment processes; perform clerical duties as needed.

DUTIES AND RESPONSIBILITIES:

• Demonstrate and maintain good work ethics.
• Perform, understand and follow PACE Policies and Procedures and provide feedback for performance improvement on medical records policies and procedures: Preparation and maintenance of medical records.

Scanning, sorting and filing records into appropriate chart.

Ensuring records are validated and accurately filed.

Purging stored paper records

Sending participant records to their community PCP if applicable

• Print and organize medical record documents for upcoming appointments.
• Reply to requests for medical records, plan benefits and eligibility.
• Request documentation from physician offices, hospitals and other facilities using the Appointment Schedule and Hospital Visit Logs.
• Maintain records/logs of physician consults, labs, hospital reports and other facility visits for collection of clinical data for reporting purposes to CMS and NPA.
• Gather participant service units quarterly for reporting purposes.
• Coordinate Personal Emergency Response (PERs) services for participants (cancelations, returning equipment, etc.).
• Assist with incoming provider invoices, claims and claims processing and contract documents and files.
• Assist with authorizing outside Provider appointments and hospitalization stays.
• Assist with Pend Reports.
• Communicate participant information to PACE Interdisciplinary Team (IDT).
• Communicate and assist with changes of Participant demographics.
• Order necessary items from Amazon as relayed from other disciplines/PACE staff.
• Collect and file all invoices accompanying incoming supplies. Deliver supplies to appropriate staff.
• Send and receive information via facsimile machine. Distribute incoming faxes to appropriate staff.
• Upload daily On-Call logs from answering service.
• Attend and participate in QI meetings.
• Attend training as required.
• Maintain strict confidentiality concerning all information pertaining to participants.
• Perform other program and agency-related services as requested.

KNOWLEDGE, SKILLS AND ABILITIES:

• Knowledge of personal computers, Microsoft Office and Windows NT software
• Good interpersonal communication skills
• Good analytical and problem-solving skills
• Good organizational skills
• Ability to maintain confidentiality.
• Ability to work with interruptions.
• Attention to detail and accuracy.