The Clinical Specialist will effectively schedule appointments to retrieve missing documentation from medical records that have been identified as missing by a Clinical Abstractor. This position works in a highly focused, demanding and timeline-driven environment.
You will need experience building relationships, overcoming objections and negotiating timelines to return appropriate documentation with Providers offices within specified timelines and goals. You will need the ability to communicate clearly while articulating potential challenges or risks to achieving goals to both internal and external team members.
SUMMARY OF DUTIES & RESPONSIBILITIES
- Place outbound calls to Provider offices with the goal of retrieving missing documentation via a fax or an on-site appointment.
- Return missed calls to the Provider the same day of the missed call.
- Follow the script as outlined in training.
- Clearly and consistently document outcome of communication with Provider office in assigned tracking tool.
- Complete HIPAA; Fraud, Waste & Abuse; and Medicare training requirements – maintain all aspects of medical documentation compliance and security
- Escalate any situations in which there is Provider abrasion to the Supervisor.
- Additional duties as assigned
REQUIRED EDUCATION & EXPERIENCE
- High School Diploma or GED.
- 1 year of experience working in a hospital, physician office or other setting in which medical terminology knowledge was needed.
- At least two (2) years of call center experience in a soft sales environment OR
- Experience effectively working in a position with high outbound call volume.
- Exemplary interpersonal, telephone and customer service skills;
- Some familiarity with medical technology;
- Basic computer proficiency (including MS Windows, MS Office, and the internet)
- Compliance with all Company policies and management instructions;
- Ability to handle multiple priorities and meet deadlines.