Enrollment & Billing Representative jobs in Charlotte, NC

Job Summary

Responsible for monitoring and evaluating any Customer Care Line Complaints, Quality Assessment and Improvement, Reappointment, and any Legal issues pertaining to the operation of the Medical Staff Office.

Essential Functions
 

• Provides oversight and guidance related to interpretation of clinical criteria to include maintenance criteria thresholds established by the medical staff and reflected on the Delineation of Privileges Forms. This process will be inclusive of appointment and reappointment processes.
• Develops and implements all aspects and processes of the Focused Professional Practice Evaluations (FPPE) in accordance with the policies and procedures for both members of the medical and dental staffs and all allied health professionals.
• Provides oversight and guidance related to the interpretation and compliance of the Policy on Occupational Health Services for Physicians and Allied Health Professionals (Immunization History).
• Functions as a liaison between Medical Records departments, patients, families, administrators of various facilities, physicians and/or Allied Health Professionals to assist in rectifying any complaints and/or quality issues received in Medical Staff Services; and referring individual cases if and when appropriate.
• Provides administrative support to the medical staff departments. Responsibilities include preparation of meeting material, attendance, record and produce minutes, providing all follow up as requested by the medical staff or administration.
• Acts as an education resource between Medical Staff Services and Corporate Risk Management and/or Quality Assessment on policies and procedures.
• Maintains responsibility for clinical interruption of all Delineation of Privileges forms approved by the Medical Staff and Board of Commissioners.
• Serves on Regulatory Readiness Committees in order to focus on assisting Medical Staff with compliance and quality data in relation to credentialing.
• Assists in the preparation of all end-of-year correspondence for the various Chiefs/Chairmen, Presidents of Medical Staffs, and hospital administrators.
• Assists in the preparation of recommendations to the Medical Executive Committees for presentation at the Quality Care and Comfort Committee of the Board of Commissioners of The Charlotte-Mecklenburg Hospital Authority.

Physical Requirements

Performs most work under normal office conditions. May include sitting for long periods of time, standing, working on computer, preparing reports and other statistical data, talking on the telephone with patients, physicians, and/or legal services, walking, using repetitive wrist/arm motion frequently and lifting boxes of files being transported between facilities in personal car. Must be able to work rapidly and accurately under pressure, to work in a safe and effective manner, and to handle different issues and priorities simultaneously.

Education, Experience and Certifications
 

Graduate of an accredited School of Nursing & licensed by the North Carolina Board of Nursing required. Basic Life Support for Healthcare Provider (BLS HCP) from AHA. 3-5 years experience in a healthcare setting required. Formal education in Risk Management and/or Quality Assurance is preferred.