UNM Medical Group
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Ambulatory Clinics Frontline Specialist
at UNM Medical Group
UNMMG Clinical Operations Group
Commensurate with experience
# of Openings:
Position/Title: Ambulatory Clinics Frontline Specialist
FLSA: Non- Exempt
FOR BEST CONSIDERATION DATE: OPEN UNTIL FILLED
UNM Medical Group, Inc. (UNMMG) is the practice plan organization for physicians and other medical providers associated with the UNM Health Sciences Center. UNM Medical Group, Inc. is a New Mexico non-profit corporation and is an equal opportunity employer. UNMMG offers a competitive salary and an attractive benefit package which includes medical, dental, vision, and life insurance as well as tuition assistance, paid leave and 403b retirement for benefits eligible employees.
The Clinical Operations Group is looking for a highly motivated Frontline Specialist to work with our multi-specialty clinics. You will work closely with dynamic team members to provide exceptional support to our clinics and patients. You will serve as a point of contact for frontline inquires to include but not limited to: registration, scheduling, order processing, insurance verification and prior authorizations. Maintain ongoing communication with UNMMG frontline staff. Responsible for coordinating and processing all referrals and prior authorization requests for our clinics.
If this position sounds interesting to you and you would like to share your expertise with our team, we invite you to apply
The following statements are intended to describe, in broad terms, the general functions and responsibility levels characteristic of positions assigned to this classification. They should not be viewed as an exhaustive list of the specific duties and prerequisites applicable to individual positions that have been so classified.
Under general supervision, serves as a liaison between UNMMG and its stand-alone satellite clinics in the coordination of frontline services. Works in collaboration with Practice Management Specialists in coordinating and providing frontline training to new hires. Assists by providing guidance and support to clinic staff in areas of scheduling, registration, pre-registration, insurance verification and prior authorization.
Duties and Responsibilities
- In collaboration with Practice Management Specialists, serves as a point-of-contact for frontline inquiries. Develop a relationship with UNM Medical Group, Inc. (UNMMG) clinic staff by directing the day-today activities of registration, scheduling, order processing, insurance verification, and prior authorizations.
- Work closely with Practice Management Specialists to develop and maintain Frontline Resource Manual.
- Conduct Frontline Training for processes to include: Registration, Financial/Cash Management, Billing, Prior Authorizations, Scheduling, Mail/Courier process, End of day processes, computer programs- IDX and Cerner.
- Obtain Healthxnet access for employees who will need to verify insurance eligibility.
- Maintain ongoing communication and dialog with UNMMG frontline staff and notify of any insurance notifications or changes to contracted/non-contracted insurance companies.
- Communicates all Payer Alerts, from Office of Clinical Contracting, with all UNMMG clinics.
- Responsible for coordinating and processing all referrals and prior authorization enter into Power Chart. Interface with insurance companies to obtain prior authorizations; may coordinate multiple authorizations and coverage; compiles medical documentation necessary to ensure prior authorization is obtained; updates computer systems to ensure final prior authorization is documented in UNMMG computer systems.
- Maintain record keeping and filing systems; gathers, enters, and updates required data.
- Serves as backup support for clinic Pre-Registration as assigned.
- Work with Practice Management Specialists in Process Development.
- Performs miscellaneous job-related duties as assigned.
Minimum Job Requirements
High school diploma or GED with at least 2 years of directly related experience acquired working in a medical environment. Verification of education and licensure (if applicable) will be required if selected for hire.
Knowledge, Skills and Abilities Required
- Strong written and verbal communication skills.
- Records maintenance skills.
- Skill in the use of computers and related software applications; ability to learn new software.
- Demonstrated ability to multi-task and prioritize work.
- Knowledge of medical records, billing and/or coding.
- Knowledge of HMO, PPO, Medicare, Medicaid, insurance plans.
- Demonstrated ability to work with private data and maintain confidentiality.
Conditions of Employment
- A valid New Mexico Driver's License, or ability to obtain a valid NM Driver's License within six months of hire, is required for this job.
- Travel to UNMMG offices and clinics may be required in this position.
- Must be employment eligible as verified by the U.S. Dept. of Health and Human Services Office of Inspector General (OIG) and the Government Services Administration (GSA).
- Must pass a pre-employment criminal background check.
- Fingerprinting, and subsequent clearance, is required.
- Must provide proof of varicella & MMR immunity or obtain vaccinations within 90 days of employment.
- Must obtain annual influenza vaccination.
- If this position is assigned to a clinical area, successful candidate will be required to complete a pre-placement medical evaluation/health screen. Required N-95 mask fitting, testing, vaccinations to include annual TST, Tdap, and Hepatitis B will be determined based on location and nature of position.
Working Conditions and Physical Effort
- Work is normally performed in a typical interior/office work environment.
- No or very limited exposure to physical risk.
- No or very limited physical effort required.
- Sedentary Work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body.
- Work involves sitting most of the time, but may involve walking or standing for brief periods of time. Walking and standing are required only occasionally and all other sedentary criteria are met.