Description
Risk Management Specialist
SUMMARY OF POSITION: Perform a variety of Risk Management support functions.
DEPARTMENT: Risk Management
REPORTING RELATIONSHIP: Risk Manager, RN
DRESS CODE: Professional
MAJOR DEPARTMENT RESPONSIBILITIES:
1. Answer Risk Management incoming calls with a welcoming voice; assist and direct callers as appropriate.
2. Assist in creating letters and reports for On-Call, Risk Management, and Committees as requested.
3. Review and document Advance Directives (Living Will/Surrogate and DNR forms) into Practice Partner.
4. Monitor delinquent documentations in charts monthly, and produce report for Risk Manager.
5. Monitor chronic delinquent dictation until resolved.
6. Assist with the Malpractice accounting (spreadsheets for billing, etc.).
7. Review and log incident reports that are forwarded to the MCC’s General Liability carrier.
8. Prepare legal files for any malpractice or general liability cases.
9. Prepare monthly report of incident reports.
10. Submit MAG (malpractice) apps to Fisher Brown for new physicians and mid-level providers; inform them of terminated physicians and mid-level providers.
11. Coordinate credentialing process for all new physicians and mid-level providers:
a. Conduct NPDB and AMA search and provide copies to necessary parties
b. Obtain malpractice face sheet from insurance carrier and provide copy to Provider Enrollment
c. Obtain copies of medical license, DEA, board certifications, and verify accuracy of information provided on Provider Enrollment application
d. Obtain malpractice tail certification from physician for previous practice
e. Maintain documentation that new physicians complete at orientation meeting with the Risk Manager, RN, and/or the Medical Director.
12. Coordinate document storage and retrieval, to include assisting in the development of an electronic database management system in the near future.
13. Answer MCC’s On-Call Referral line with a welcoming voice. Assist patients by: finding a physician that suits their needs; finding a physician that accepts the insurance of the patient; providing information about availability of appointments. Work as patient advocate in accessing care.
14. Assist MCC staff in finding resources for both staff and patients.
15. Maintain records on calls received through the On-Call Referral Program.
16. Create monthly and cumulative year-end reports and provide information for supervisors and Administration for the On-Call Referral Program.
17. Assist in creating marketing tools (internal and external), in developing marketing strategies (internal and external), and in educating physicians and staff about availability of the On-Call Referral Program.
18. Market MCC and the physicians, services, and staff through the On-Call service materials sent to patients/significant others.
19. Order and maintain office supplies.
MAJOR CORPORATE CULTURE RESPONSIBILITIES:
1. Follow established corporate and department-specific policies and procedures
2. Attend all corporate and department-specific required training.
3. Comply with MCC Service Standards:
* MAKE FIRST IMPRESSIONS POSITIVE ONES. Greet all patients, visitors and co-workers in a pleasing manner with eye contact, a verbal greeting, and a smile. Offer assistance to anyone who appears lost or in need. Walk patients to their destination rather than pointing the way; use good elevator etiquette.
*MAINTAIN A PROFESSIONAL APPEARANCE. Wear your name badge at all times. Comply with the uniform policy for your department or job description. Confine gum chewing and eating to break areas; save personal conversations for break times; turn off non-work related cell phones. Maintain a neat and clean work area, both in your department and throughout MCC.
*DEMONSTRATE A POSITIVE ATTITUDE. Interact with all patients, visitors, and co-workers in a professional and upbeat manner. Be courteous, respectful, friendly, and helpful. Express yourself and your concerns using helpful words versus confrontational words or profanity. If you are unable to maintain a positive approach, remove yourself from the situation.
*DEMONSTRATE A TEAM ATTITUDE. Remember you are part of a team, and the success of MCC is everyone’s responsibility. If you don’t know how to assist a patient or co-worker with an issue, find someone who can. Be personally responsible for making sure issues are addressed.
*MAKE LASTING IMPRESSIONS POSITIVE ONES. Maintain patient privacy and confidentiality at all times. End your interactions with patients, visitors and co-workers with a friendly or kind word. Make sure patients waiting alone at the front door have transportation home.
4. Perform other duties as may be assigned cheerfully and willingly.
Requirements
1. Demonstrated customer-service skills.
2. Be a person of integrity and character, willing to embrace change make a positive impact in the lives of patients and co-workers.
3. Ability to work with staff members at all levels of the organization in a cooperative, team-oriented manner.
4. Minimum education requirement is high school diploma or GED.
5. Certified or registered Medical Assistant.
6. Must be able to type 40 cwpm.
7. PC literate in windows environment; ability to use a variety of software applications to include but not necessarily limited to Microsoft Word, Excel, Access, Outlook Express and the Internet.
8. Proficient in use of English language in both verbal and written communication.
9. Ability to operate telephone, printer, copier, calculator, and fax machine.
10. Ability to communicate effectively, by speaking clearly and distinctly, and being easily understood, on a consistent basis throughout the workday.
11. Ability to effectively communicate with individuals of varying socio-economic backgrounds.
12. Ability to sit for extended periods of time.
13. Ability to look at a computer screen for extended periods of time.
14. Constant, repetitive use of the hands and fingers.
15. Good visual acuity to check for accuracy of the transcribed product.
16. High level of concentration.
17. Ability to work in close proximity with others and maintain a professional atmosphere.
18. Ability to remain calm and professional, regardless of the intensity of the workload or time constraints.
19. Ability to remain calm and professional during emergency situations.
