Medical representative job description

Pre-Authorization/Medical Forms Representative Elmhurst Physician Practice Division Registry - as needed Location:# Center for Health, Elmhurst# This position is responsible for reviewing a variety of clinical documentation to ensure completeness of the information in order to process referrals, pre-authorizations and FMLA/Disability and other forms as assigned per payer guidelines, and forms completion.# Supports providers and patients through the timely preparation, submission and communication of requests and status.## Education, Experience and/or Skills Required: # Minimum of one year of experience in a medical office setting # Previous experience with electronic medical records # Strong customer service focus # Detail oriented # Ability to multi-task and work in a fast paced environment # Strong oral and written communication skills # Ability to maintain confidentiality# Education, Experience and/or Skills Preferred: # Associates Degree # Medical Assistant training# # A minimum of two years of experience processing referral, prior authorizations or medical necessity verifications.## # High level of understanding of FMLA/Disability laws and processes # Medical terminology # Prior Epic experience # Bilingual
Pre-Authorization/Medical Forms Representative

Elmhurst Physician Practice Division

Registry - as needed

Location: Center for Health, Elmhurst

This position is responsible for reviewing a variety of clinical documentation to ensure completeness of the information in order to process referrals, pre-authorizations and FMLA/Disability and other forms as assigned per payer guidelines, and forms completion. Supports providers and patients through the timely preparation, submission and communication of requests and status.

Education, Experience and/or Skills Required:

* Minimum of one year of experience in a medical office setting
* Previous experience with electronic medical records
* Strong customer service focus
* Detail oriented
* Ability to multi-task and work in a fast paced environment
* Strong oral and written communication skills
* Ability to maintain confidentiality

Education, Experience and/or Skills Preferred:

* Associates Degree
* Medical Assistant training
* A minimum of two years of experience processing referral, prior authorizations or medical necessity verifications.
* High level of understanding of FMLA/Disability laws and processes
* Medical terminology
* Prior Epic experience
* Bilingual

CORE JOB DUTIES
Agent Support and Management:
• Duties include the oversight of all operations; developing operating plans to meet objectives; and assuring standard operating procedures are up-to-date and produce the desired results.
• Builds relationships with employees and contractors. Analyzes and troubleshoots issues and implements required changes.
• Proven management experience in the medical marijuana industry required; must possess a thorough understanding of legal and compliance issues.
• Serves as the designated representative in accordance with Ohio Administrative Code 3796.
• Experience will include dispensary or other healthcare facility preferably with a retail or regulatory component.
• Implements business strategies, plans, and procedures and oversee operations of the dispensary and the work of each key employee.
• Must have proven experience in a highly regulated industry with all business functions including human resources, bookkeeping, staffing, and training, quality assurance and customer service.
• Responsible for performing or assigning the duties of unfilled positions on the organizational chart as necessary.
• Responsible for managing dispensary staff, schedules, inventory, and patient/customer relations.
• Serves as a resource for dispensary staff concerning products and services, policies and procedures, industry news and changes in regulations.
• Responds to all staff questions, concerns or suggestions.
• Resolves any conflict immediately.
• Responsible for delegating tasks to all Bliss Ohio team members in order to maintain a compliant and clean facility.
• Coordinates with the upper management to ensure accurate information is communicated to dispensary staff.
• Managing and implementing training on POS system.
• Serve as a liaison to the local community and area health providers.
• Coordinate patient outreach and educational programming (with input from grow/processors and marketing team).
• Interface with IT managers to develop and continually assess technology implementation and adjust based on business needs.
• Maintain in-depth knowledge of every product and strain in the store, as well as industry-wide product knowledge.
• Stay abreast of customer and business trends and actively communicate with ownership to provide input on retail and strategic business initiatives.
• Ensure that physical environment is safe, sanitary, and that all equipment/technology is in good working order.
• Lead initiatives, store strategies, and specific projects at the store level that may be assigned by executive-level management.

Customer Service:
• Provides superior customer service for vendors, patient/customers and caregivers.
• Responds to all patient/customer complaints, requests, concerns, suggestions.
• Oversees orders and deliveries to ensure accurate order information and timeliness of deliveries.

Reports, Documentation and Profitability:
• Maintain accurate records of all dispensary activities including daily cash reconciliations, patient/customer records, sales, deliveries and returns in accordance with the State of Ohio and the standards set by Bliss Ohio.
• Accurate daily, weekly, and monthly recaps and reporting from sales data and patient counts.
• Maintain inventory control system and perform daily counts of all medical cannabis and medical cannabis products in the facility.
• Provide regular inventory, sales, and profitability reports to the Management Team.

Work Experience:
• Managerial experience in a medical cannabis retail environment.
• Considerable exposure to retail cultures focused on well-developed standard operating procedures and management and employee training programs.
• Experience in inventory management and reconciliation.
• Human Resources management experience including hiring, training, records management, performance reviews, payroll processing, and more.
• Work history that demonstrates stability, progressive responsibility, and willingness to accept new duties.

Capabilities and Skills:
• Exceptional team building, communication and people skills.
• High level of integrity and a strong work ethic.
• Exceptional willingness to be a hands-on manager and fill gaps to accomplish business objectives.
• Proficiency in computer usage including retail point-of-sale software, all MS Office applications, email, scheduling software, online conferencing, and more.
• Ability to develop, analyze, and interpret key performance metrics, and read, analyze, and interpret financial reports relating to dispensary performance metrics.
• Strong problem-solving skills including anticipatory thinking and the ability to work well under pressure while maintaining a calm composure.
• Demonstrated ability to work comfortably and effectively within a diverse, multicultural, multigenerational environment.

ADDITIONAL REQUIREMENTS
• Must be 21 years of age or older to apply
• Must comply with all legal or company regulations for working in the industry

Job Type: Full-time
Pay: Annual Salary plus incentives based on experience

Bliss Ohio is an Equal Opportunity Employer and all applicants will be considered without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran, or disability status.

Company DescriptionAt Bliss, we exist to help people explore ways to find their complete happiness.

We believe in the power of medical cannabis as an alternative way to treat qualifying medical conditions, such as chronic pain, cancer, arthritis, Alzheimer’s, Crohn’s, PTSD, along with other conditions that limit people’s ability to live their life to its fullest.

Whether in person or online, our Omni brand experience is driven by highly knowledgeable, dedicated team members who are passionate about helping people find solutions to their ailment/malady/condition.

We are approachable, welcoming, educated, patient & passionate. By exploring all five senses, we seek to inspire health, healing and hope for your complete holistic experience. We are Bliss Ohio.

Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that is improving the lives of millions. Here, innovation is not about another gadget; it is about making health care data available wherever and whenever people need it, safely and reliably. There is no room for error. If you are looking for a better place to use your passion and your desire to drive change, this is the place to be. It's an opportunity to do **your life's best work.(sm)**

The **HIM Representative** is responsible for operational processes related to entering clinical documentation into the Electronic Medical Record. This person will support Health Information Management Department operational processes by collecting and preparing documentation for entry into the Electronic Medical Record (EMR); scan and index clinical documentation under supervision; provide customer services via phone and fax.
**Primary Responsibilities:**

+ Ensures that paperwork is properly scanned and indexed into the Electronic Medical Record

+ Minimum of daily scanned documents is 600 pages

+ Faxes stat requests for records to other facilities

+ Scan and file all imported and paper documents

+ Prepares/documents request for Release of information to Ciox

+ Answer incoming calls for the H.I.M Department

+ Responds to patient enquires related to Release of Information: assist patients with questions about their medical records

+ Participates in quality assurance audits and other initiatives as directed by management

+ Perform other projects and duties as related to clinical area as requested

+ Ensures HIPAA and legal guidelines are followed in all interactions with patients and in handling of the health record

Monday-Friday, 8:00 AM-5:00 PM, No Weekends, No Holidays.

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.

**Required Qualifications:**

+ High school diploma OR GED equivalent

+ 1+ years of experience with HIM terminology

+ Proficient in computer skills (Expected to learn how to use EPM, Touchworks, NextGen ICS and other clinical software within the first year)

+ Basic knowledge of HIPAA guidelines (important to representing the Health Information Management Department work to patients and other clinical staff)

+ 10-key skills

+ Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation.

**Preferred Qualifications:**

+ 1+ years of experience as a Medical Records Clerk

+ Organizational and time management skills

+ Astute attention to detail and excellent communication skills, both oral and written

_To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment._

**Careers with Optum.** Here's the idea. We built an entire organization around one giant objective; make health care work better for everyone. So when it comes to how we use the world's large accumulation of health-related information, or guide health and lifestyle choices or manage pharmacy benefits for millions, our first goal is to leap beyond the status quo and uncover new ways to serve. Optum, part of the UnitedHealth Group family of businesses, brings together some of the greatest minds and most advanced ideas on where health care has to go in order to reach its fullest potential. For you, that means working on high performance teams against sophisticated challenges that matter. Optum, incredible ideas in one incredible company and a singular opportunity to do **your life's best work.(sm)**

_Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law._

_UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment._