Duties:

Duties:

JOB OBJECTIVE

This position will work under the supervision of the Billing Manager.  The Billing Specialist will be responsible for the completion of all tasks to ensure accurate, compliant and timely billing of patient charges for appropriate reimbursement from all sources, such as patients and all other third party payers.   Billing Specialists will interact with a multi-cultural population of diverse socioeconomic backgrounds, ages, and level of education.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The Billing Specialist is responsible for performing the following duties:

• Reviews charges, payments and adjustments to ensure accuracy and compliance with billing, coding and any contractual requirements  
• Generates paper or electronic claims and submits them to all third party payers such as Medi-cal Medicare, private insurances and other programs
• Generates patient statements and collection letters
• Enters payments received from payers and patients in the practice management system
• Reviews claim rejection queue and resolves for resubmission
• Follows up on denied and unpaid claims; works closely with payers  to provide any information necessary to receive payment
• Reviews and collects on overdue patient balances
• Answers questions from patients, staff and payers
• Reviews and processes requests for adjustments, corrections or refunds
• Prepares billing reports
• Collaborates and communicates with other team members to ensure efficiency of processes
• Maintains billing records
• Performs other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.

Duties:

JOB OBJECTIVE

Under the general supervision of the Medical Director or Nurse Manager, the Clinical Agent will be provide nursing care to patients by way of limited patient assessment via telephone, assisting with appointment coordination, and collaboration with others within and outside the organization. Primary objective is to engage with patients and improve coordination of care. 

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The Clinical Agent is responsible for performing the following duties:

• Monitors and responds to patient inquiry calls.
• Assists with the evaluation and assessment of patient's health care needs based on patient's signs and symptoms utilizing established triage protocols and guidelines. 
• Effectively and efficiently uses clinical decision-making tools and algorithms.
• Reports accurate medical information to assist provider with decision making.
• Appropriately identifies patients with urgent needs and triages them with a provider to refer either to the emergency department or urgent care for evaluation.
• Provides appropriate health advice within the scope of their licensure/certification to patients who do not require immediate in person care with a provider.
•  Documents accurate notes of all conversations and patient interactions in the patient’s EMR.
• Patient Education: Offer educational resources and information to patients.
• Collaboration: Work with other healthcare professionals to ensure comprehensive patient care.
• Schedules appointments for patients who need to see a CDCR provider, consulting with providers as appropriate.
• Assists with supporting patients with medication questions i.e. frequency processing refill requests as dictated by prescribing provider.
• Serve as a clinical resource and professional role model for other staff.
• Communicates appropriately and tactfully with staff, consultants, patients and their families, and the community.
• Provides a timely response to inquiries, which may take place via telephone or alternative communication platforms such as text messaging.
• Participates in staff, training, and other meetings as needed. May be responsible for development of training materials or policies & procedures. Performs other duties as assigned, including scheduling and outreach calls.

Duties:

JOB OBJECTIVE

The Customer Service Representative handles customer service inquires and problems via telephone, email or written correspondence. Answers questions and resolves issues based on phone calls/letters from members, providers and plan sponsors. Explains member’s benefits, rights and responsibilities in accordance with contract and uses applicable system tools and resources to produce quality letters and spreadsheets in response to inquiries received.

ESSENTIAL DUTIES AND RESPONSIBILITIES INCLUDE:

The Customer Service Representative will be responsible for:

• Provide exceptional customer service via telephone
• Adjust greeting to real time environment displaying empathy for the member’s inquiry
• and/or situation
• Ensures customer satisfaction by providing quality service, identifying customer needs and assisting them with issues/concerns related to insurance benefits, provider contracts, eligibility and claims.
• Deliver accurate, concise information that result in the member feeling confident that the service request has been understood and resolved.
• Analyze problems and resolve the Provider, Member and Health Plan issues over the telephone on the first call as often as possible.
• Research, identify and problem solve, verify eligibility of service and place call backs as required. Assure timely follow-up and set appropriate expectations on all pending cases.
• Ensure Provider Claims Inquiries are resolved timely.
• Thoroughly documents inquiry outcomes for accurate tracking and analysis. Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
• Seeks, understands and responds to the needs and expectations of internal and external customers. Provides external and internal customers with requested information.
• Maintain key performance metrics on outbound/inbound calling programs. Meet and support established service goals and business objectives by meeting and exceeding performance standards.
• Adapts communication style to persons representing diverse personal, professional, cultural, and socio-economic backgrounds.
• Ability to multi-task; simultaneously thinks, talks, and types.
• Uses excellent hearing and listening skills to receive detailed information while utilizing good probing skills.
• Requires knowledge of company services, products, insurance benefits, provider contracts and claims.
• Perform other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.

Duties:

Looking for Dental Assistant or Registered Dental Assistant

The Dental Assistant (DA) supports and provides chair-side assistance to Dentists. Assists with set-up of equipment, prepares patient for treatment and assists during procedures. The DA works under the supervision of the Dentist and Lead Registered Dental Assistant (RDA) and reports to the Health Center Manager. Interprets Dentist’s orders in terms understandable to patients of varied educational and cultural backgrounds. Works with a multi-cultural population of diverse socioeconomic backgrounds and ages.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Under the direct supervision of the Dentist or Lead RDA, the DA may perform the following duties:

• Sterilizes, prepares and arranges equipment and accessories.
• Keeps dental department and equipment neat, clean and sanitary.
• Utilizes common dental instruments, equipment and materials.
• Utilizes and understands dental terminology.
• Takes digital dental x-rays.
• Instructs patients in the proper practices of dental hygiene.
• Assists in the dental laboratory.
• Documents patient visits utilizing electronic dental records.
• Mixes amalgam.
• Takes impressions for diagnostic and opposing models.
• Removes sutures.
• Places and removes rubber dams.
• Places wedge and removes all matrices. Holds anterior matrices.
• Applies topical fluoride after scaling and polishing is provided by the supervising Dentist.  
• Applies non-aerosol and non-caustic topical agents.
• Removes post-extraction and periodontal dressings.
• Assists in the administration of gases; does not adjust the flow of the gases unless instructed to do so by Dentist who shall be present at the patient’s chair-side at the implementation of these instructions. This regulation shall not be construed to prevent any person from taking appropriate action in the event of a medical emergency.
• Assists with orthodontic procedures such as placing and removing elastic orthodontic separators, taking intra-oral measurements for orthodontic procedures, seating adjusted retainers or headgears, checking for loose bands, removing arch wires and ligature ties.
• Interacts in a professional manner and works collaboratively with Clinicas’ staff and patients.
• Provides excellent customer service to patients, vendors and employees.
• May assist patients with mental illness, substance abuse problems and or/emotional disturbance.
• Perform other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.

Duties:

JOB OBJECTIVE

Under the general supervision of the Health Education Outreach Coordinator and oversight from the Director of Health Education and Prevention Programs, the Health Education Outreach Specialist (HEOS) performs a variety of community services: health education community classes, health screenings and linking community to health care services.  The HEOS will primarily work in the community with specific target populations to promote Clinicas’ services in agricultural fields, packing houses, food pantries, and other community organizations, primarily focused on the farmworker and migrant target population throughout Ventura County. The HEOS interacts with a multi-cultural population of diverse socioeconomic backgrounds, ages and levels of education.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The HEOS is responsible for performing the following duties:

• Researches and verifies patient eligibility for different medical programs. 
• Registers and interviews patients to obtain accurate and complete demographic information.
• Informs patients about the availability of governmental funded and discount programs.
• Recruits new patients for CDCR and schedules appointments.
• Conducts community presentations and health screenings.
• Serves as an interpreter between provider and patient as needed.
• Conducts education at the appropriate level in a variety of areas including but not limited to preventative care, prenatal care, reproductive health, nutrition, chronic diseases, oral health and pediatrics.
• Utilizes a variety of resources to provide education including Department curricula, written educational materials, brochures, posters, models and videos.
• Conducts maternity tours at the contracted hospitals for prenatal patients as needed.
• Provides patient advocacy including assistance with community referrals, disability & paid family leave forms, WIC, medication assistance and other advocacy services aiding as a liaison to connect patients to resources.
• Promotes services via in-person, broadcast & social media as requested.
• Documents encounters using electronic health records, HED data base and other applicable forms.
• Will be required to both capture and provide information that is of a sexual health nature which will involve family planning. 
• May assist patients with mental illness, substance abuse problems and or/emotional disturbance.
• Performs other duties as assigned including participation in all safety programs, which may include assignment to an emergency response team.
• Must have and maintain a valid driver license.

KNOWLEDGE AND ABILITIES

• Ability to work individually as well as in group settings with minimal supervision.
• Work with people of different cultural, ethnic, and social-economic backgrounds, particularly underserved populations and have a desire to help others improve their health.
• Must have dedication to team work and the ability to deliver exceptional patient service.
• Must have strong communication skills.
• Possesses excellent computer skills and have basic knowledge of computer programs (Word, Excel, Publisher, etc.).
• Interacts in a professional manner and works collaboratively with Clinicas’ staff and patients. Provides excellent customer service to patients, vendors and employees.
• Possess strong desire to improve the health and well-being of target populations. Be a self-motivated, independent, innovative thinker and a resourceful problem solver.
• Must have a flexible work schedule and be available to work weekends and evenings as requested.
• Complete and maintain program certifications as assigned by supervisor.
• Must have reliable transportation to be used during working hours for off-site appointments and outreach activities. 

Duties: The Health Educator I will be under the general direction of the Health Education Coordinator designing, developing, and implementing Health Education programs and materials for the community clinic. Responsible for developing and implementing a marketing program to promote the organization’s services. Compiles and prepares monthly and quarterly reports to various funding programs. Assists in the in-house training of staff updating education programs and teaching skills. Assists in the in-house training of staff updating education programs and teaching skills. Researches plans, develops and implements health education programs using existing staff and other community resources; assists in the development of pamphlets, flyers, publicity, and other education materials for community clinic patients; provides feedback to Health Education Coordinator for planning of patient programs to meet organization’s goals and objectives; develops and implements a marketing program to increase awareness of organization’s services; serves as advisor and assists program staff in developing pre-testing, and utilizing patient health education materials connected with specific programs; participates in recruiting and training outreach staff; other duties as assigned by the Health Education Coordinator. Knowledge and planning and developing health education programs; general health guidelines; research methodology; marketing techniques and knowledge of education programs for prenatal/postnatal high risk patients and infant care. Ability to conduct need assessment of rural communities; function effectively as a health care team member; interpret goals and objectives; identify and network with community resources of rural Ventura County; participate in developing health education policy and procedures; collaborate with Federal, State, County and community organizations concerning the need for quality patient health education programs and resources.

Duties:

The Lead Licensed Vocational Nurse (LVN) provides nursing services to ambulatory care patients and in emergency settings when necessary. Performs skilled tasks and paraprofessional nursing duties requiring specialized training. The Lead LVN reports to the Health Center Manager and works under the direct supervision Medical Provider when providing patient care. Interacts with a multi-cultural population of diverse socioeconomic backgrounds, ages and levels of education.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The Lead Licensed Vocational Nurse performs the following duties:

• Provides nursing care to Health Center patients.
• Conducts patient screenings and assists provider with triaging
• Physically and psychologically prepares patients for treatments, examinations, and scheduled diagnostic studies.
• Sets up for minor procedures
• Instructs patients on proper use of medical equipment and teaches them skills to care for their particular medical needs.
• Is responsible for recognizing and interpreting symptoms and reporting condition of patient to the attending physician.
• Documents patient visits utilizing electronic health records system (EHR).
• Keeps inventory of stock medicines available and makes weekly drug and medical supply orders. 
• Administers treatment and medication under physician’s orders, except for intravenous medications.
• Verifies and administers immunizations upon physicians’ or standing orders.
• Prepares in-house monthly EHR reports.
• Provides supervision of Licensed Vocational Nurse and Medical Assistant personnel.
• Provides Licensed Vocational Nurses (LVN) and Medical Assistants with their assignments so as to ensure an effective and functional Health Center.
• Coordinates patient flow activities and assists with peer review of patient records in their quality of care system.
• Provides assistance in the development, planning and implementation of new and existing nursing policies and procedures.
• Ensures that policies are followed consistently and correctly by the LVN and Medical Assistant staff.
• Participates in the interview process and selection of LVN’s and Medical Assistants.
• Is responsible for facility orientation, training and supervision of immediate staff. 
• Participates in Quality Improvement as necessary.
• Adheres to and follows established nursing policies, procedures and practices.
• Is actively involved and communicates with the Health Center Manager and all respective staff to ensure sharing of information, problem solving and effective operation of the Health Center.
• Assists with and/or facilitates coaching and disciplinary process for staff. 
• Composes and delivers employee performance evaluations, skills checklists and performance plans when necessary.
• Presents at Staff Meetings and Quality Assurance Meetings.
• Presents information during daily team huddles.
• Conducts Clinical Orientation Trainings
• Coordinates MA/Nursing schedule
• Conducts monthly chart reviews.  
• Adheres to universal precautions.
• Adheres to and follows established nursing policies, procedures and practices.
• May float to other Clinicas sites when additional coverage is needed.
• May be required to approve employee timesheets and requests for time off.
• Interacts in a professional manner and works collaboratively with Clinicas’ staff and patients.
• Provides excellent customer service to patients, vendors and employees.
• May assist patients with mental illness, substance abuse problems and or/emotional disturbance.
• Due to the nature of the job, may work with or be exposed to information or material of a sexual nature.
• Performs other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.

Duties:

The Licensed Vocational Nurse (LVN) provides nursing services to ambulatory care patients and in emergency settings when necessary. Performs skilled tasks and paraprofessional nursing duties requiring specialized training. The LVN reports to the Health Center Manager and works under the direct supervision of the Lead Licensed Vocational Nurse and Medical Provider when providing patient care. Interacts with a multi-cultural population of diverse socioeconomic backgrounds, ages and levels of education.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The Licensed Vocational Nurse performs the following duties:

-         Provides nursing care to Health Center patients.

-         Conducts patient screenings and assist provider with triaging.

-         Physically and psychologically prepares patients for treatments, examinations, and scheduled diagnostic studies.

-         Instructs patients on proper use of medical equipment and teaches them skills to care for their particular medical needs.

-         Is responsible for recognizing and interpreting symptoms and reporting condition of patient to the attending physician.

-         Documents patient visits utilizing electronic health records system.

-         Keeps inventory of stock medicines available and makes weekly drug and medical supply orders. 

-         Administers treatment and medication under physician’s orders, except for intravenous medications.

-         Verifies and administers immunizations upon physician’s orders.

-         Prepares in-house monthly EHR reports.

-         May provide supervision of Medical Assistant personnel.

-         Coordinates patient flow activities and assists with patient records audit for their quality of care system.

-         Participates in Quality Improvement as necessary.

-         Adheres to and follows established nursing policies, procedures and practices.

-         May float to other Clinicas sites when additional coverage is needed.

-         Interacts in a professional manner and works collaboratively with Clinicas’ staff and patients.

-         Provides excellent customer service to patients, vendors and employees.

-         May assist patients with mental illness, substance abuse problems and or/emotional disturbance.

-         Due to the nature of the job, may work with or be exposed to information or material of a sexual nature.

-         Performs other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.

Duties:

The Medical Assistant I, II, III (MA) performs clinical and administrative duties in support of medical Providers. Interprets Providers’ orders in terms understandable to patients of varied educational and cultural backgrounds. Interacts with a multi-cultural population of diverse socioeconomic backgrounds and ages. Reports to the Health Center Manager and works under the direct supervision of medical professional staff, Lead Nurse, Lead LVN or Lead Medical Assistant

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The Medical Assistant is responsible for performing the following duties:

• Interviews patients to obtain medical information and measures their vital signs.
• Escorts patients to exam rooms and prepares for the medical provider.
• Documents patients’ medical history, vital statistics and information such as test results in the electronic health records (EHR) system.
• Collects blood, tissue or other laboratory specimens as requested by medical provider and prepares them for testing.
• Prepares and administers medications as directed by medical provider.
• Translates and explains treatment procedures, medications, diets and medical provider’s instructions to patients.
• Performs blood draws, administers immunizations and injections.
• Prepares treatment rooms for patient examinations, keeping the rooms neat, clean and fully stocked.
• Cleans and sterilizes instruments and disposes of any contaminated supplies.
• Changes dressings on wounds.
• Contacts medical facilities or departments to schedule patients’ tests and/or admissions (on as-needed basis).
• Performs general office duties such as answering phones and completing forms when necessary.
• Takes inventory and orders medical, lab and office supplies and equipment.
• Maintains logs for recall purposes.
• Performs routine laboratory tests and performs daily testing controls.
• Operates electrocardiogram (EKG), and other equipment to administer routine diagnostic tests.
• Adheres to and follows universal precautions.
• Adheres to and follows established nursing policies, procedures and practices.
• Rotates to other Health Centers as needed.
• Interacts in a professional manner and works collaboratively with Clinicas’ staff and patients.
• Provides excellent customer service to patients, vendors and employees.
• May assist patients with mental illness, substance abuse problems and or/emotional disturbance.
• Due to the nature of the job, may work with or be exposed to information or material of a sexual nature.
• Performs other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.

Duties:

The Patient Services Representative (PSR) works under the supervision of the Health Center Manager. The PSR is the first point of contact for our patients and some of the duties include: • Greeting patients upon arrival and assisting them through the registration process. • Receives payments. • Completes patient’s intake forms and determines eligibility for patients’ ability to pay or their qualification in assistance programs. • Schedules and confirms appointments and works closely with the back-office to ensure an efficient and pleasant visit for our patients.

Duties:

The Registered Dental Assistant (RDA) supports and provides assistance to Dentists chair-side. Assists with set-up of equipment, prepares patient for treatment and assists during procedures. The RDA works under the supervision of the Dentist and Lead Registered Dental Assistant and reports to the Health Center Manager. Interprets Dentist’s orders in terms understandable to patients of varied educational and cultural backgrounds. Works with a multi-cultural population of diverse socioeconomic backgrounds and ages.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

Under the direct supervision of the Dentist or the Lead RDA, the RDA/RDAEF may perform the following duties:

• Sterilizes, prepares and arranges equipment and accessories.
• Keeps dental department and equipment neat, clean and sanitary.
• Utilizes common dental instruments, equipment and materials.
• Utilizes and understands dental terminology.
• Takes digital dental x-rays.
• Instructs patients in the proper practices of dental hygiene.
• Assists in the dental laboratory.
• Documents patient visits utilizing electronic dental records.
• Mixes amalgam.
• Takes impressions for diagnostic and opposing models.
• Removes sutures.
• Places and removes rubber dams.
• Places wedge and removes all matrices. Holds anterior matrices.
• Applies topical fluoride after scaling and polishing is provided by the supervising Dentist. 
• Applies sealant.
• Performs coronal polishing.
• Applies non-aerosol and non-caustic topical agents.
• Removes post-extraction and periodontal dressings.
• Assists in the administration of gases; does not adjust the flow of the gases unless instructed to do so by Dentist, who shall be present at the patient’s chair-side at the implementation of these instructions. This regulation shall not be construed to prevent any person from taking appropriate action in the event of a medical emergency.
• Assists with orthodontic procedures such as placing and removing elastic orthodontic separators, taking intra-oral measurements for orthodontic procedures, seating adjusted retainers or headgears, checking for loose bands, removing arch wires and ligature ties.
• Interacts in a professional manner and works collaboratively with Clinicas’ staff and patients.
• Provides excellent customer service to patients, vendors and employees.
• May assist patients with mental illness, substance abuse problems and or/emotional disturbance.
• Perform other duties as assigned including participation in all safety programs which may include assignment to an emergency response team.

Functions specific to RDA Extended Functions: (These duties are to be performed under direct supervision of a licensed Dentist. Procedures shall be checked and approved by the supervising dentist prior to dismissal of the patient.)

• Cord retraction of gingivae for impression procedures
• Takes impression for cast restorations, space maintainers, orthodontic appliances and occlusal guards.
• Prepares enamel by etching for bonding
• Formulates indirect patterns for endodontic post and core castings
• Fits trial endodontic filling points
• Applies pit and fissure sealants
• Removes excess cement from subgingival tooth surfaces with a hand instrument
• Applies etchant for bonding of restorative materials

Duties:

JOB OBJECTIVE

The Patient Services Representative (PSR) provides front office clerical and administrative support to the Health Center’s medical, dental, optometry and mental health departments. Works under the supervision of the Health Center Manager. Works with a multi-cultural population of diverse socioeconomic backgrounds, ages and levels of education.

 

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES

The PSR may be responsible for performing some or all of the following duties:

• Provides excellent customer service to patients, vendors and employees
• Interacts in a professional manner and works collaboratively with Clinicas’ staff and patients
• Works in a fast-paced environment and proactively analyze and resolve problems
• Assists patients with completion of intake forms
• Answers phones; documents telephone calls when applicable
• Determines if patient qualifies for sliding fee program; refers patients to enrollment specialist when necessary
• Verifies insurance eligibility; submits insurance authorization requests as required by insurances
• Receives and posts payments with correct payer code to patient accounts
• Collection of payment at time of service
• Scans documents into proper categories in patients’ electronic health record
• Schedules new and follow-up appointments; confirms next-day appointments
• Adheres to front desk policies and procedures
• Updates patient files utilizing Electronic Health Records
• Processes requests for Release of Records by reviewing, copying or typing special letters/summaries of records as indicated by Provider or Health Center Manager
• Reviews daily charges
• Works closely with back office staff to prioritize patients that need to be triaged
• May assist patients with mental illness, substance abuse problems and or/emotional disturbance
• Performs other duties as assigned including participation in all safety programs, which may include assignment to an emergency response team

Benefits

This is an excellent opportunity to work for an organization that truly makes a difference in the community. Clinicas Del Camino Real, Inc. offers a highly competitive salary; excellent benefit package including full medical, dental, vision, life and disability insurance; generous holiday, vacation and sick leave.

Requirements

EDUCATION, EXPERIENCE AND QUALIFICATIONS

High school diploma or equivalent required.  Must have one year of clerical and/or customer service experience, preferably in a medical, dental, optometry or mental health office.  Proficiency with use of computers and basic programs is required.  Must communicate professionally and effectively in writing and orally; accurate spelling and grammar are necessary. Bilingual in English and Spanish is preferred. Must have the ability and desire to provide excellent customer service.  Knowledge of Medi-Cal and insurance billing requirements is desirable, including ICD-9/ICD-10 and CPT codes. Must have reliable transportation, as may be required to rotate to other Health Centers as needed.