Clear & Legible Reporting Clerk (GCII)

Company: Choctaw Staffing Solutions, Inc.
Location: Bremerton
Posted on: May 15, 2022

Job Description:

Clear and Legible Reporting Clerk Services/General Clerk II Naval Hospital Bremerton, WA Clear and Legible Reporting Clerk (CLR Clerk) services to be provided for the Naval Hospital Bremerton, WA (hereafter referred to as "the MTF"). Implementation of the Tricare contracts has necessitated changes in referral/consultation processing. The tracking, managing and obtaining of results for referrals to and from civilian providers, is the sole responsibility of the respective medical treatment facility (MTF). The CLR Clerk personnel will be assigned to the Naval Hospital Bremerton, WA. The Contractor is expected to provide a wide range of CLR services to DOD beneficiaries including Active Duty, Reserve component, National Guard, Retired Service members, Family members, and other persons eligible for DOD healthcare at each location including: The Referral Management Department. QUALIFICATIONS 1. Possess experience using basic software applications, e.g. Microsoft Word and Excel. 2. Possess one year of experience interpreting coding records. 3. Requirements for current certification in American Heart Association Basic Life Support (BLS) for Healthcare Providers or American Red Cross CPR (Cardio Pulmonary Resuscitation) will be specified in the task order if applicable. 4. Be a U.S. Citizen per Enclosure 5. Possess a High School Diploma or GED certificate. 6. Possess one year of experience providing medical administrative support services. TASKS Employees shall perform a full range of tasks consistent with their profession, education, training, experience, and assigned responsibilities. General requirements that apply to all contractor employees are provided below. 1. The contractor shall follow the MTF Standard Operating Procedures (SOPs) to provide administrative support services to the MTF. 2. The contractor shall receive, greet, and inform patients, visitors, and hospital personnel and provide accurate responses in a friendly, courteous, and concerned manner. 3. The contractor shall fax, copy, scan, print, and type documents to complete daily tasks listed within this contract and the MTF SOPs. 4. The contractor shall utilize the Composite Healthcare System (CHCS), the Armed Forces Health Longitudinal Technology Applications (AHLTA), and various other databases in support of patient care and to satisfy administrative requirements. 5. The contractor shall maintain a level of productivity comparable with that of other individuals performing similar services. 6. The contractor shall complete orientation training required by the MTF for new personnel. 7. The contractor shall complete all annual training required by the MTF. This includes annual information awareness training and HIPAA training. TASKS FOR CLEAR AND LEGIBLE REPORTING (CLR) SUPPORT 1. The contractor shall review all incoming CLRs for accuracy, completeness, and legibility and posting of consultation reports for patients referred both to and from providers. 2. Contact the physician's office, if an incoming report does not meet the CLR standards. 3. The contractor shall notify MTF providers when a CLR is posted and monitor timelines of incoming CLRs. 4. The contractor shall provide CLR receipts validation and shall cross-check referral authorizations against claims adjudicated. 5. The contractor shall properly document patient responses in CHCS, AHLTA, and the Referral Management System/Referral Management System Tracking Reports and Health Artifact and Image Management Solution (HAIMS). The contractor shall provide notification to the referring Provider of patient requests to cancel referrals. 6. The contractor shall contact Provider offices to determine if patient was seen and if so, acquire referral results. The contractor shall properly close referrals in CHCS and the Referral Management System/Referral Management System Tracking Reports appropriately and shall forward informational advisement of the referral status to the initiating MTF provider or PCM. Contacts shall be documented per MTF instructions. 7. The contractor shall assist with the return of completed consult reports to civilian providers for patients seen within the MTF under ROFR. ROFRs shall be processed within the time limits outlined in the TRICARE Operations Manual, Chapter 8, Section 5 CLR CLERK SERVICE PERSONNEL: In addition to the tasks in the basic contract, the Contractor shall provide the following tasks, in a professional manner, to include, but not limited to, the following CLR work: 1. The contractor shall use various software applications to record, retrieve, correct, merge, query or print data and reports. Programs and software utilized by the Government and TRICARE contractor include, but are not limited to, Composite Health Care System (CHCS), Defense Enrollment Eligibility Reporting System (DEERS), access to databases, electronic fax applications, Referral Management System/Referral Management System Tracking and Reports, Healthcare Artifacts and Image Management Solution (HAIMS), Armed Services Health Longitudinal Technology Application (AHLTA), and Electronic Medical Record databases. The contractor shall use Microsoft Office products including Outlook, Word, Excel, and Access. 2. The contractor shall research, process, upload into HAIMS and forward to the referring provider/ Primary Care Manager (PCM) for review. 3. The contractor shall complete referrals within the MTF; shall identify problem areas and provide guidance to staff to correct errors, and shall advise MTF staff on referral tracking procedures. 4. The contractor shall complete routine periodic reports that include, for example, the percentage of referrals that are verified or closed correctly, and ensure all referrals that are deferred to the network are appropriately closed, i.e. results obtained or facility administratively closed the referral. 5. The contractor shall properly document patient responses in Electronic Medical Records (EMR), and the Referral Management System/Referral Management System Tracking Reports and HAIMS. The contractor shall provide notification to the referring provider of patient requests to cancel referrals. 6. The contractor shall retrieve referrals sent from the TRICARE Regional Contractor and apply processes necessary for acceptance or denial by the MTF. The contractor shall proactively seek assistance when indicated by guidelines, Standard Operating Procedures, and/or when questions arise. The contractor shall maintain a customer-centered focus in all activities. 7. The contractor shall establish/maintain suspense files for referrals deferred to the network and shall compile and maintain data for reporting and tracking purposes. Approximately 3,000 per month/36,000 per year actions are required. HOURS OF OPERATION. 1. The contractor shall provide personnel to provide services Monday through Friday between the hours of 0630 and 1600. Services are not required on weekends or federally observed holidays. The above-noted job description is not intended to describe, in detail, the multitude of tasks that may be assigned but rather to give the applicant a general sense of the responsibilities and expectations of this position. As the nature of business demands change so, too, may the essential functions of the position. EEO/AAP Statement We acknowledge and honor the fundamental value and dignity of all individuals. We pledge ourselves to craft and maintain an environment that respects diverse traditions, heritages, and experiences. Choctaw is an Equal Employment Opportunity and Affirmative Action employer. We do not discriminate based upon race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Choctaw Staffing Solutions is full-service staffing and employment agency. Choctaw Staffing Solutions (CSS) delivers pre-qualified healthcare professionals that are licensed and credentialed to national industry standards and regulations. CSS provides behavioral health providers and mental health services to support the U.S. Government. CSS offers a variety of administrative services, ranging from Human Resources to logistics and facilities to help desk support. PI176763160

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