GENERAL SUMMARY:

Under the supervision of the Operations Team Lead, the Operations Support Specialist is responsible for answering the phone, greeting and directing consumers, and responding to walk-in, telephone, internal, web, and faxed consumer requests for services.  Additional duties include determining scheduling options for initial intake and ongoing appointments; initiating the referral process for all TCMHS programs respective to position location and completion of all required referral forms within the electronic health record (EHR).  Through the check-in and check-out process, the CSR receives and records outstanding self-pay balances and updates the consumer record with changes in demographics. 

Responsibilities also include responding to emergency calls, referring consumers to crisis services as appropriate; providing general operations support (i.e.filing, distributing mail, faxing) to respective location program and staff; providing individual one on one support with assigned enhancement team members. 

ESSENTIAL JOB FUNCTIONS:*

Demonstrates commitment to the mission of the agency with a strong understanding and respect for the goals of agency activities.

Professionally greets consumers, both face-to-face and via the telephone; provides general service information and directs callers and visitors to appropriate departments.

Professionally responds to telephone/faxed, walk-in, and internal referrals in addition to entering the data into the electronic health record.

Responsible for the daily opening and closing of the office as assigned.

Determines scheduling options/ for initial intake and ongoing assignments based on consumer pay-source, required provider credentialing, and clinician availability.

Verifies consumer Medicare/MaineCare coverage and/or eligibility.

Maintains program wait lists.

Responsible for securing initial Outpatient authorizations through Kepro, as well as monitoring and alerting clinical staff when CSR's are required.

Updates consumer demographic date in the electronic medical record (EHR)

As assigned, generates daily encounter forms, addressing balances, financials, demographic updates.

Researches and clears suspended billing items for identified programs daily.  Alerts provider and Lead in necessary steps required to secure payment, and updates the tracking spreadsheet accordingly.

Facilitates any change in client pay source.

Assists consumers as needed with coordination of public transportation.

Coordinates interpreter services for hearing and language requirements as assigned.

Independently responsible for scheduling of initial consumer assessment, as well as ongoing appointments.  Works in collaboration with Clinical Lead in scheduling for Behavioral Health Homes.

Initiates the referral process by, gathering presenting problem, demographics and paysource information.

Through the use of various portals, verifies MaineCare and Medicare coverage, checks for alerts within the Maine Sex Offender Registry and notifies appropriate individuals when necessary.  Generates Preliminary Assessment, assignments and client categories.

Completes admissions process upon intake, gathering and documenting various demographic, financials and legals, as well as ensuring authorizations are secured, either through the Authorization team, or by initiating authorization request through Kepro.

Initiates basic payment arrangement; collects and posts outstanding self-pay balances, including payment agreement amounts and co-payments

As assigned, completes daily/weekly/monthly deposits according to procedures.

Completes all steps in the discharge process within the electronic health record and Kepro.

May provide billing support as assigned.

Monitors activity in the waiting room, and takes appropriate action when warranted according to protocol, to include initiating the supervisor on-call system.

Ensures wait area is well maintained, including review of bulletin board postings for appropriate materials and posts information as directed by supervisor.

Works collaboratively with peers , Team Leads, clinical staff in backfilling various responsibilities when staffing or time management issues arise.

OTHER DUTIES AND RESPONSIBILITIES:

Completes and submits required documentation in a timely manner and according to policies and procedures.

Participates in training to maintain or enhance job skills.

Ensures that confidentiality is maintained at all times in accordance with federal, state, and agency standards.

Participates in scheduled meetings, supervisory sessions, staff meetings, and other inter/intra agency meetings as appropriate for the position.

Adheres to the agency's Risk and Safety Management Programs.

Adheres to the agency's Organizational Standards for Performance (see attached).

Functions in a cost-effective manner with regard to the utilization of time, supplies and other agency resources.

May use personal vehicle for agency-related business as required.

Represents Operations on the Move Team, SWAT Team, and completes ergonomic assessments as necessary

Performs other related duties as required

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WORKING CONDITIONS/PHYSICAL DEMANDS:

Normal office environment, not subject to extreme variations of temperature, noise, odors

Minimal physical effort required; normally seated with the freedom of movement on a regular basis; handling of materials and supplies

May spend extended periods at terminal, on telephone, or operating other office machines, requiring eye-hand coordination and finger dexterity

More than half of time spent in normal office setting

The above statements are intended to describe the general nature and level of work being performed by people assigned to do this job.  The above is not intended to be an exhaustive list of all responsibilities and duties required.  The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position.

*External and internal applicants, as well as position incumbents who become disabled as defined under the Americans With Disabilities Act, must be able to perform the essential job functions (as listed) either unaided or with the assistance of a reasonable accommodation to be determined by management on a case by case basis.

This job description does not constitute an employment agreement between the employer and employee, and is subject to change by the employer, as the needs of the employer and requirements of the job change.