Careers

MEDICARE INSURANCE CLERK

Following up on Medicare claims status and denials.  Researching to have claims processed in a timely manner.

1. High school graduate or equivalent.

2. Computer experience

3. At least one year experience working insurance follow up with knowledge of the Medicare modifiers and other guidelines for physicians.

4. Must know how to use CPT book and ICD-10 book. At least 2 - 4 weeks of training is required.

5. Must have knowledge of medical and medical business office terminology. (EOB, RA, EFT, etc.)

CERTIFIED PHARMACY TECHNICIAN

PURPOSE OF POSITION

      To assist the Pharmacist with all the duties including opening the Pharmacy in the mornings, waiting on customers, answering phones, filling prescriptions, and closing the pharmacy in the evenings.

                      PRIMARY DUTIES AND RESPONSIBILITIES

1. Prepares for the day; unlocking doors, turning on lights, and getting computers ready for the day.
2. Waiting on Customers: taking the information needed to process their prescription.
3. Put the information in computer and processing them.
4. Fill the prescription: running the prescription through the computer, counting the medication, putting it in a vial for the pharmacist to label.
5. Taking the money for the medication, ring up on cash register.
6. Processing orders: sending orders to Walsh by way of computer; checking in next morning, updating inventory in register and computer then stocking the item on the shelf.
7. Close out register in afternoon and doing the deposit.
8. Third party: keeping a running total on all accounts.

                                 GENERAL DUTIES

1. Works under minimal supervision within general policies and

             standards of the clinic.

2. Follows instructions of the Pharmacist.
3. Attends clinic and/or department meetings as scheduled.
4. Keeps in confidence all matters pertaining to the clinic,

             its employees or its patients.

5. Other duties and responsibilities as  assigned by the

             Pharmacist, or Administrator.

                                 QUALIFICATIONS

1.   Pleasant, friendly disposition with the ability to work with

             patients as well as employees and physicians.

2. Awareness of need for discretion and for keeping confidential

             all matters relating to the clinic, the employees and the

             patients.

3. Intelligence to use judgement and initiative determining the

             course of action in a particular situation.

4. Ability to handle stressful situations while remaining calm.
5.   Tact and diplomacy when dealing with staff.
6. Interpersonal skills and communication abilities.
7. Maturity to withstand pressures that may arise in relation to

             the public, personnel or physician.

8. Able to work in a team situation while promoting harmony and

             cohesiveness within the department.

9. Close working relationship with Pharmacist.

CASE MANAGEMENT - PEDIATRICS

Strategically manage services for specified patient population. Provide a focus on wellness, prevention, and efficient care through the coordination with patients, their families, and physicians. The education of the patient and his/her family will be incorporated into the care plan after careful assessment of the patient’s knowledge base, home life, and post-acute resources. The Case Manager will play a vital role in the clinical, financial and education of patients and will ensure these aspects are all considered simultaneously throughout the continuum of care. The Case Manager will ensure the patient receives the right services at the right level of care and will assist the patient in navigating their own care at an optimum level.

1. The ability to demonstrate knowledge and effectiveness of Case Management principles in the following health care areas; processes, relationships, management, community resources, service delivery, psychosocial interventions and all other areas of Case Management.
2. Establish collaborative working relationships with patients, providers and resources.
3. Communicating with and obtaining the approval of the patient and or the parent to arrange appropriate care.
4. Keep patients well informed by telephone and in writing of activities/case summaries.
5. Demonstrate sensitivity to issues and show pro-active behavior in addressing client and patient needs.
6. Promotes health education and provides literature to patients to enhance understanding of a condition, treatment or procedure.
7. Assist patients in addressing questions to their physician
8. Follow and monitor patient outcomes
9. Utilize appropriate community health care resources to maximize patients healthcare outcomes.
10. Maintain confidentiality and adheres to HIPAA requirements
11. Document clinical information completely, accurately and in a timely manner
12. Other duties as assigned.

1. Current LVN/LPN or RN license.
2. Experience with Medicaid population a strong plus.
3. Must possess knowledge of CPT/ICD-9/10 codes.
4. Two – three years experience of utilization or Case Management preferred.
5. Knowledge of managed care principles regarding legal and regulatory requirements and confidentiality preferred.
6. Must have excellent communications and presentations skills.
7. Demonstrates diplomacy and professionalism when dealing with staff or patients.

LVN/LPN or CMA - FLOAT

Must have current LPN/LVN License or be a Certified Medical Assistant.