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Phelps County Regional Medical Center Prevention & Denial Specialist in Rolla, Missouri

General Summary

  • This position supports the Denial, Prevention, and Recovery Department (DPR) by providing administrative assistant and Data Analyst services to the DPR department as well as the care management department. Additionally, this position is responsible for maintaining the inpatient and outpatient audit tracking software system and is responsible for the management of clinical and financial data within the tracking system, reports, and other tasks that may be assigned by the Denial and Prevention Director or Manager. Also serves as a contact person/liaison between auditors/external resources.

    Essential Duties and Responsibilities

  • Assists with patient medical records to compile all requested documentation in the format stipulated and within the timeframe requested by CMS.

  • Tracks audit requests/appeals/due dates/correspondence.

  • Communicates with Auditing agencies regarding records/audits/appeals.

  • Compiles reports for the Denial & Prevention Department.

  • Provides administrative and clerical support to the Care Managers/Manager/Director.

  • Keeps information organized and accessible, maintains clean/functional work space, works systematically/efficiently, and manages time well.

  • Participates in departmental projects as needed.

  • Manages departmental correspondence, mail, and tracking spreadsheets.

    Job Qualifications

  • Education

  • High School diploma or equivalent required. Additional medical clerical education preferred.

  • Work Experience

  • One year of medical clerical experience required. Will accept education in lieu of experience.

  • Certification/License

  • Not applicable

    Mental/Physical Requirements

  • Considerable mental concentration. Ability to receive and express detailed information through oral and written communications. Excellent interpersonal and organizational skills.

    Working Conditions

  • Standard Office Conditions

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