Alutiiq General Clerk II in Tamuning, United States
General Clerk II
Provide Referral Management Clerk services for the Referral Management Center within the Directorate of Healthcare Business (DHB) at U.S. Naval Hospital, Guam.
Provide Referral Management Clerk services to provide a wide range of administrative and clerical support services to DOD beneficiaries including Active Duty, Reserve component, National Guard, Retired Service members, Family members, and other persons eligible for DOD healthcare. The work includes functions as described in this Performance Work Statement (PWS).
Provide services at the following locations: United States Naval Hospital Guam, Bldg #50, Farenholt Ave, Tutuhan, 96910.
Retrieve and review referrals submitted in AHLTA and CHCS. Approximately 1,100 referrals shall be processed each month. Referrals shall be processed by faxing or utilizing other electronic systems to the appropriate internal provider/clinic or external provider/medical facility. If a TRICARE authorization is required, the referral will be sent via a secured system to International SOS for authorization.
If additional or amplifying information is requested from TRICARE ISOS, the Contractor shall contact the referring provider for any returned referral to obtain the information and continue with the referral process.
Review Clear and Legible Reports (CLRs) for accurate provider and patient demographic information and legibility. Upload reports into the patient’s Electronic Medical Record, AHLTA and Health Artifact and Image Management Solution (HAIMS). If an incoming report is not legible, has incomplete patient demographic information, inaccurate patient demographic information, the contractor will contact the civilian physician’s office and request an acceptable report. Notify the referring provider via email or by generating a Telephone Consult in AHLTA once the CLR is uploaded.
Review and compare CLRs to the original referral in the local database and update the electronic record to receipt and closure of the CLR.
Investigate delinquent CLR reports to determine the reason for delinquency and document appropriately to close the referral. Approximately 100 transactions shall be completed each month.
Contact TRICARE civilian network provider offices to obtain missing reports if there is no evidence that the consult has been fulfilled or contact the patient to advise them of the status of their referral and to determine their intent with respect to the referral. Approximately 100 transactions shall be processed each month.
Notify the patient, the referring provider, and DHB leadership of referrals that are not processed or closed out within the allotted timeframe. All correspondence with the patient shall be annotated in the patient’s electronic health record via AHLTA.
Contact patients by phone who are referred to MTF specialty clinics to schedule appointments in CHCS. Approximately 50 calls a month shall be made.
Enter approximately 200 ancillary orders a month into CHCS. Ancillary orders are documented on a valid authorization from VA CBOC providers.
Validate benefits of all Veteran Administration (VA) beneficiaries scheduled for specialty clinic appointments. Approximately 55 transactions shall be completed each month. Validation of benefits shall be completed the day before the schedule appointment. If the beneficiary’s benefits are not validated the Referral Management Clerk notify the VA Registered Nurse Case Manager to obtain a valid authorization.
Contribute in the development of and update the Referral Management Center Standard Operating Procedure (SOP).
Participate in the department’s monthly teleconference facilitated by Navy Medicine West.
It is estimated that 1,100 medical referral transactions shall be processed each month.
Possess two years of experience providing medical administrative support services.
Possess a High School Diploma or GED certificate.
Possess experience using basic software applications, e.g. Microsoft Word and Excel.
Ability to understand and follow instructions precisely.
Knowledge of Excel program for preparation of charts, graphs and spreadsheets.
Must have the personnel, organization, and administrative control necessary to ensure the services performed meet all the requirements specified.
Work experience shall contain experience directly related to the tasks and functions to be assigned.
Must be a US Citizen, must be able to obtain a Favorable National Background Investigation at the NCLAC level.
Tamuning, Tamuning, Guam
We respect diversity and accordingly are an equal opportunity employer that does not discriminate on the basis of race, color, creed, religion, national origin, ancestry, citizenship status, age, disability or handicap, sex, marital status, sexual orientation, gender expression or identity, veteran status, genetic information or any other characteristic protected by applicable federal, state or local laws (“protected status”). Our management team is dedicated to ensuring the fulfillment of this policy with respect to recruitment, hiring, placement, promotion, transfer, training, compensation, benefits, employee activities and general treatment during employment.