Tricore Jobs in Rio Rancho, NM (NOW HIRING)

Scheduled Hours: Monday - Friday 0800-1630 and other shifts as needed.
Location: Woodward
JOB SUMMARY: Communicates with customers, including patients, physicians, clients, providers, and internal customers and provides accurate and timely resolution. Performs clerical and administrative duties under general supervision. Ensures accurate and timely resolutions of clerical duties for all internal and external customer requests within the authority of Client Engagement. Ensures customers receive exceptional service when responding to telephone, email, or written inquiries. Prepares images, indexes, and performs Quality Assurance (QA) for requisitions, attachments, insurance cards, and Explanation of Benefits (EOBs) from commercial insurance carriers. Works missing requisition reports. Maintains onsite records storage area for the Business Office and assists Legal Services in document destruction/storage as needed.
ESSENTIAL FUNCTIONS:
1. Process Client Engagement Department mail. a. Pick up and distribute Client Engagement Department Mail from the 1 st floor mailroom. b. Distribute outgoing Client Engagement mail as appropriate. c. Research and mail outgoing patient reports.
2. Responsible for the release of medical records of laboratory patients in a manner consistent with medical, administrative, ethical, legal, and regulatory requirements of the laboratory system: a. Document and track requests for medical records. b. Review request for medical records for completeness, accuracy, and compliance with regulations and company policies; and c. Protect the security of medical records to ensure that confidentiality is maintained. d. Participate in investigations of allegations of inappropriate release of records in conjunction with the Compliance Department.
3. Receive and maintain Unlisted Report from IT, by investigating and researching Client ID and Provider Information and investigating current Client Information such as phone number, mailing address, fax number and other communication as needed, provide information to Sales Support as needed. Send these reports in US Mail as appropriate.
4. Receive and maintain Serum Protein Electrophoresis reports from Immunology for distribution.
5. Receive and maintain Powerpath PAP reports for distribution.
6. Receive and maintain monthly Cytology reports for distribution.
7. Research, monitor and distribute all incoming faxes from clients, providers and other internal TriCore departments in a timely and appropriate manner.
8. Fax results to clients and providers per requests sent by fax or from requests by email from other internal TriCore departments.
9. Maintain inventory ordering process for office envelopes, tissue paper, copy paper, and toner for the department specifications.
10.Add and Remove Providers from IT, and Business Office, CLA's from Sponsor Hospitals, and handle requests from the Supplies department.
11.Investigate Client information, such as phone, fax, address, etc.
12.Demonstrate a willingness to learn other Client Engagement tasks in order to provide front line customer service when called upon.
13.Prepares documents for scanning (i.e. Explanation of Benefits (EOB's), laboratory requisitions, and all required attachments.)
14.Scanning of documents using document scanning equipment.
15. Quality Assurance review of documents scanned into system and correction of errors. Meets all QA goals and data entry production goals.
16.Performs data entry of indexing information to look up imaged documents.
17.Works missing requisition reports, including follow-up with other departments.
18.Follows all organizational and departmental policies and procedures.
19.Maintains records storage area to include preparing boxes for off-site storage.
MINIMUM EDUCATION:
• High School diploma or equivalent.
MINIMUM EXPERIENCE:
• Six (6) months experience in a clinical laboratory or medical setting or six (6) months customer service experience.
PREFERENCES:
• Experience imaging documents
• Experience handling the release of information and medical records.