Clear & Legible Reporting Clerk (GCII)
Company: Choctaw Staffing Solutions, Inc.
Location: Bremerton
Posted on: August 7, 2022
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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.
PI187855927
Keywords: Choctaw Staffing Solutions, Inc., Seattle , Clear & Legible Reporting Clerk (GCII), Advertising , Bremerton, Washington
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