Provides leadership and overall management of all insurance and medical correspondence functions for Service Area (SA). Oversee the management of the Inpatient and Outpatient medical transcription functions at West LA. Responsible for developing and maintaining effective policies, procedures, systems, and working relationships with medical staff, other medical center and SA departments, employer groups, insurance companies, attorneys, providers, EDD, regulatory and reporting entities. Essential ... more details
Description:
Job Summary:
Provides leadership and overall management of all insurance and medical correspondence functions for Service Area (SA). Oversee the management of the Inpatient and Outpatient medical transcription functions at West LA. Responsible for developing and maintaining effective policies, procedures, systems, and working relationships with medical staff, other medical center and SA departments, employer groups, insurance companies, attorneys, providers, EDD, regulatory and reporting entities
Essential Responsibilities:
Provides strategic planning and direction for the development and enhancement of insurance and medical correspondence related services throughout the SA.
Ensures that goals and services provided by the Insurance and Medical Correspondence as well as Medical Transcription are aligned with organizational priorities.
Ensures compliance with Insurance and Medical Correspondence requirements established by federal and state laws and regulations as well as contracts with Kaiser Permanente and employer groups.
Represents the SA in Southern California division efforts to meet requirements and improve the quality of insurance and medical correspondence services.
Ensures compliance with Medical Transcription requirements established by TJC, NCQA, CMRI, medical staff bylaws, and regional and local policies and procedures.
Manages the functions performed by the Insurance and Medical Correspondence departments including: the completion of disability forms including signing the forms on behalf of the physician; compiling with request from outside agencies, hospitals and physicians as well as governmental agencies such as with subpoenas.
Timeliness and accuracy of function impacts: the member from a monetary standpoint, the organization from Performance Standards and Guarantees impact, and medical information providers use for continuity of patient care.
Responsible for the management of the functions performed by the Inpatient and Outpatient Medical Transcription Departments including: Transcription of transfer summaries, history and physicals, operation reports, consultations, nuclear medicine, discharge summaries as well as the daily clinic progress notes for five departments, i.e., Surgery, Orthopedics, Podiatry, Plastic Surgery and Pediatrics.
This department is a seven day, 20 hour a day department.
Timeliness and accuracy of functions impact the management of the patients care as well as medical center revenues.
Ensures high quality and consistency of services through establishment and implementation of quality assurance activities.
Establishes effective working relationships with SA leadership, SCPMG, Utilization Management, Nursing, Home Health and Health Information Management, Pharmacy and other users of clinical information and data.
Ensures the availability and quality assurance activities.
Provides effective financial management and efficient use of resources.
Directs the development of budgets, monitors operating expenses, analyzes variances and develops corrective action plans.
Evaluates opportunities for enhancing the cost-effective delivery of service.
Ensures effective use of medical transcription data through providing statistical analyses and reports and by consulting with other departments who utilize data for management, quality, utilization and other vital functions.
Manages and resolves human resource, employee and department safety and risk management issues.
Basic Qualifications:
Experience
Minimum seven (7) years in the health information management field.
Minimum three (3) years as a manager.
Education
Bachelors degree, or four (4) years of experience in a directly related field.
High School Diploma or General Education Development (GED) required.
License, Certification, Registration
N/A
Additional Requirements:
Good knowledge of NCQA, TJC, federal and state and local requirements for medical records.
Good knowledge of ICD-9 and CPT coding system.
Excellent supervisory skills.
Good oral and written communication skills.
Must be able to work in a Labor/Management Partnership environment.
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