Working Solutions

  • Medical Coding Data Entry Specialist

    Job Locations US-LA-Baton Rouge
    Category
    Administrative/Clerical
  • Overview

    Reviews and enters complex authorizations and referrals from VA and providers. Ability to effectively communicate medical information, test results, diagnoses and or proposed treatment in a manner easily understood by the patient. Must be able to effectively communicate with clinical staff. Ensures accurate data entry and completion of authorization data from customer information, medical records, referral/authorization forms, assists Patient Service Representatives (PSRs) in obtaining consult reports within required turnaround times. Provides initial data entry related to potential quality issues. Under the direction of a supervisor, requests appropriate records and process initial review of those records. Works in a fast-paced work at home environment.

    Responsibilities

    • Conducts research to ensure accurate documentation of the patient's clinical information.
    • Review and respond to complex referral requests from VA and civilian providers with appropriate coding and provider selection.
    • Responds to inquiries from Veterans and providers regarding specific aspects of the VA program. Information and assistance includes referrals, authorizations, and the location and use of network and certified providers.
    • Consistently display professional and courteous service skills to internal and external customers.
    • Takes appropriate measures to comply with HIPAA regulations to protect privacy of Veteran’s health information.
    • Documents the transmission of medical referrals to the facility or the network provider in line with procedures.
    • Documents all communications involving Veteran and provider contacts.
    • Develops knowledge of various software applications, including procedures and processes of the VA program.
    • Assesses faxed or emailed documents, to ensure appropriate entry into the medical management system.
    • Works with standard coding systems including: standard medical taxonomy, International Classification for Diseases, Current Procedural Terminology, and Health Care Common Procedure Coding System.
    • Verifies and ensures that appropriate referral procedures are followed for the various types of VA eligible beneficiaries. Ensures procedures are followed for referrals based on Veteran category geographical location and the provider's request.
    • Enters data into the medical management system.
    • Identifies potential quality of care or safety issues.
    • Requests medical records as directed, scans records into the medical management system, and prepares records for quality of care review.
    • Identifies potential discrepancies in the medical management system to assure quality compliance.
    • Consistently meets productivity and performance metrics.

    Qualifications

    Experience

    • At least one full year experience in a medical office or health care environment, which includes data entering medical records or information
    • Knowledge of medical terminology normally obtained through a medical certification OR experience using, interpreting and applying ICD and CPT codes
    • Experience using Microsoft Office, the Internet and medical/health systems
    • College course working  the healthcare or equivalent field

    Competencies

    • Technical Skills: Working knowledge of medical terminology and the authorization and referral process;  Telephone customer service and analysis skills; Proficient with data entry into on-line systems;  Ability to cope in a fast-paced work at home environment and to effectively utilize multiple systems to perform function.
    • Team-Building / Team Player: Influence the actions and opinions of others in a positive direction and build group commitment.
    • Problem Solving / Analysis: Ability to solve problems through systematic analysis of processes with sound judgment; Has a realistic understanding of relevant issues.
    • Organizational Skills: Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; Detail-oriented.
    • Information Management: Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.
    • Communication / People Skills: Ability to influence or persuade others under positive or negative circumstances; Adapt to different styles; Listen critically; Collaborate.
    • Commitment to Task: Ability to conform to established policies and procedures; exhibits high motivation.

    Contractors on this program will need to successfully pass a background check to work. The background check will consist of a social security number verification, national sex offender registry report and a criminal history check.

     

    We are currently not accepting applications from candidates residing in CA, NY, PA or WA.

     

     

    PM16

    Options

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed

    General Interest? Connect with us.

    Join our talent community to stay in touch and then apply to be a Working Solutions agent.