Clinical support:
- Assist the dermatologist with patient examinations and procedures.
- Assist in all surgical and cosmetic procedures.
- Prepare and administer medications as directed by a physician.
- Collect and prepare laboratory specimens for testing.
- Perform basic laboratory tests and maintain laboratory equipment.
- Sterilization and knowledge of how to safely use an autoclave.
Patient Interaction:
- Greet and escort patients to examination rooms.
- Document patient history and current complaints in their medical records.
- Explain treatment procedures and physician instructions to patients.
- Provide patient education on health maintenance and disease prevention.
Administeration Roles:
- Schedule patient appointments and manage appointment calendars.
- Maintain and update patient records in electronic health record (EHR) systems.
- Handle billing and coding for insurance claims and patient billing inquiries.
- Prior Authorization through Cover my Meds, BSBC
- Send in prescriptions as requested by the provider.
- Answer phones, respond to patient inquiries, and handle correspondence.
Compliance and Safety:
- Ensure compliance with healthcare regulations and safety standards.
- Sterilize medical instruments and ensure a clean and functional workspace with properly disposing of sharps and use of the autoclave.
- Follow infection control protocols and dispose of biohazard waste properly.
Professional Development:
- Maintain certification through continuing education and re-certification as required.
- Stay informed about advances in medical assisting and changes in healthcare regulations.
Qualifications:
- Certification as a Medical Assistant
- NCCT Nationally Certified
- Excellent interpersonal and communication skills.
- Proficiency in using electronic medical records (EMR) and office software.
- Strong organizational skills and attention to detail.
An NCMA is integral in providing efficient, compassionate care and ensuring the smooth operation of healthcare facilities, acting as a bridge between patients and providers.
An Independent Claims Adjuster File Reviewer specializes in assessing and auditing claims files to ensure compliance with company standards, regulatory requirements, and accuracy. This role involves a detailed review of claims documentation and supporting materials to ensure proper handling and resolution. Below is a typical job description:
Title: Independent Claims Adjuster File Reviewer
1. File Review and Evaluation:
- Conduct comprehensive reviews of claims files across property, casualty, and workers' compensation to assess accuracy, completeness, and adherence to policies and procedures.
- Verify that claims are processed in compliance with industry regulations and company standards.
2. Quality Assurance:
- Identify discrepancies, errors, or inconsistencies within claims files and recommend corrective actions.
- Ensure documentation standards are met, including proper record-keeping of all communications and transactions.
3. Analysis and Reporting:
- Analyze claims to ensure appropriate settlement values and fair handling.
- Prepare detailed reports on findings, including patterns or trends that may require further action or policy changes.
4. Feedback and Recommendations:
- Provide feedback and guidance to claims adjusters on best practices and areas for improvement.
- Recommend improvements in claims handling processes and assist in the development of training materials.
5. Regulatory Compliance:
- Ensure claims handling adheres to applicable legal and regulatory requirements.
- Stay updated on changes in laws and regulations affecting claims processing.
6. Collaboration and Communication:
- Collaborate with adjusters, supervisors, and other stakeholders to resolve complex or high-value claims.
- Effectively communicate findings and recommendations to management and other relevant parties.
Qualifications:
- Extensive experience in insurance claims adjusting, with a focus on property, casualty, and workers' compensation.
- Strong analytical and problem-solving skills.
- Excellent attention to detail and organizational skills.
- Proficiency in using claims management software and other relevant technology.
- Strong communication and interpersonal skills to provide constructive feedback and recommendations.
- Relevant certifications or licensure as required by state insurance regulations.
This role is crucial in maintaining the integrity and efficiency of the claims process by ensuring that all files meet the necessary standards and requirements.
A General Manager in the HVAC (Heating, Ventilation, and Air Conditioning) industry oversees the daily operations of the business, making strategic decisions to ensure efficiency, profitability, and customer satisfaction. Here’s a general outline of their job roles and responsibilities:
Job Title: General Manager/Administration - HVAC
Responsibilities:
1. Operational Oversight:
- Oversee all aspects of the company's operations, including installation, maintenance, and repair services.
- Ensure projects are completed on time, within budget, and to the customers' satisfaction.
2. Team Leadership:
- Manage and lead a team of HVAC technicians, customer service personnel, and administrative staff.
- Recruit, train, and develop staff, fostering a positive and productive work environment.
3. Financial Management:
- Develop and oversee budgets, ensuring financial targets are met or exceeded.
- Analyze financial data, prepare financial reports, and implement cost-control measures.
4. Sales and Marketing:
- Develop and execute sales and marketing strategies to increase market share and revenue.
- Build and maintain relationships with customers, suppliers, and business partners.
5. Customer Relations:
- Ensure high levels of customer service and satisfaction by monitoring feedback and addressing concerns promptly.
- Implement policies to enhance customer experience and service delivery.
6. Strategic Planning:
- Develop long-term business strategies and set performance goals to ensure the company’s growth and sustainability.
- Identify new business opportunities and areas for expansion or diversification.
7. Regulatory Compliance:
- Ensure all operations comply with industry standards and regulations, implementing changes as necessary.
- Stay informed about industry trends, regulations, and technological advancements.
Quality Control:
- Maintain high-quality standards in service delivery and product offerings.
- Implement and monitor quality assurance programs and processes.
Qualifictions:
- Proven experience in a managerial role within the HVAC or related industry.
- Strong leadership and team management skills.
- Excellent financial acumen, with experience in budgeting and financial analysis.
- Strong understanding of HVAC systems, operations, and industry standards.
- Excellent communication and negotiation.
1. Environmental Science - Studying the interaction between humans and the environment, including topics like ecology, conservation, and sustainability.
2. Human Anatomy and Physiology 1&2: A detailed examination of the human body's structures and functions, often with a focus on medical applications.
3. Microbiology with Lab: The study of microorganisms, including bacteria, viruses, fungi, and their effects on other living organisms.
4. Genetics: An exploration of heredity, genetic variation, and the molecular basis of genes.
5. College Algebra
6. Public Speaking
Basic electives that were taken include:
1. English Composition: Focuses on writing skills, critical thinking, and communication.
2. General Biology with laboratory scene
3. Social Sciences: Courses like psychology, sociology, or introductory anthropology fall into this category.
5. Humanities: literature, art
6. Foreign Language: Spanish
7. Information Technology: Basic computer or information science courses are often required to ensure proficiency with technology.
8. Communications: This may include public speaking or interpersonal communications.
9. Psychology
10. Sociology
Basic courses aim to prepare students for more advanced studies in their major and equip them with essential skills for their future careers
Administrative Skills
1. Medical Terminology: Understanding the language used in healthcare, including prefixes, suffixes, and root words.
2. Medical Billing and Coding: Learning how to process insurance claims and understand coding systems like ICD-10 and CPT.
3. Healthcare Laws and Regulations: Familiarity with HIPAA regulations, patient privacy, and other legal aspects of healthcare.
4. Patient Scheduling: Skills for managing appointments, coordinating care, and handling patient inquiries.
5. Electronic Health Records (EHR): Training on how to document patient information and manage electronic records.
Clinical Skills
1. Basic Patient Care: Techniques for taking vital signs (blood pressure, pulse, temperature), preparing patients for examinations, and assisting during exams.
2. Phlebotomy: Learning how to draw blood for tests and understanding basic laboratory procedures.
3. Administering Medications: Knowledge of dosage calculations, routes, and techniques for administering medications.
4. Injections: Training in how to give intramuscular, subcutaneous, and other types of injections.
5. Assisting with Minor Surgical Procedures: Learning how to prepare and assist in minor surgeries or procedures.
6. Infection Control: Understanding sterilization, sanitization, and safety procedures to prevent infection.
7. First Aid and CPR: Training in basic first aid techniques and CPR certification.
Professional Skills
1. Communication: Developing effective communication skills for interacting with patients, providers, and other healthcare professionals.
2. Patient Education:Learning how to provide patients with information regarding their health conditions and treatments.
3. Time Management and Organization: Skills for managing multiple tasks and maintaining an efficient workflow in a clinical setting.
Administrative Skills Related to Prior Authorizations
1 Understanding Insurance Policies:
- Familiarity with different types of insurance plans (eg, HMO, PPO) and their coverage requirements
- Knowledge of which services typically require prior authorization based on insurance guidelines
2 Communication Skills:
- Effectively communicating with patients to explain the prior authorization process and its importance
- Interacting with insurance providers to gather required documentation and follow up on authorization requests
3 Documentation:
- Maintaining accurate patient records, including all necessary supporting documents needed for prior authorizations
- Understanding the specific information required by insurers, such as diagnosis codes, treatment plans, and test results
4 Data Entry and Electronic Health Records (EHR):
- Proficiency in entering and retrieving patient information using EHR to facilitate the prior authorization process
- Ensuring that all relevant patient data is up to date and accessible for processing requests
5 Research Skills:
- Ability to research and interpret insurance guidelines and requirements for prior authorization specific to different procedures and medications
6 Attention to Detail:
- Carefully reviewing submitted requests to ensure all necessary information and documentation are included, minimizing delays or denials
Clinical Skills Related to Prior Authorization
1 Basic Patient Care Knowledge:
- Understanding the medical necessity of certain treatments or procedures, as well as common diagnostic and procedural codes used in prior authorizations
2 Patient Education:
- Educating patients about the reasons for prior authorization and potential delays in their care
- Guiding patients on how prior authorization affects their treatment options
The Process of a Prior Authorization
1 Initiating the Prior Authorization:
- Collecting information from the healthcare provider, including clinical details and required documentation
- Submitting the request to the insurance company via fax, phone, or online portal
2 Follow-Up:
- Monitoring the status of pending prior authorization requests and following up as necessary
- Communicating any updates to patients and providers, including any additional information the insurance company might request
Nationally Certified Medical Assistant
Insurance Adjuster (Property, Casualty, and Workers’s Compensation)