The Alternative Living Group, Inc.
  • 13-Sep-2022 to Until Filled (EST)
  • Schenectady, NY, USA
  • 16.00
  • Hourly
  • Full Time

The Medical Direct Support Specialist will carry a caseload of residential homes to assist in completing medical follow up, obtaining necessary documents, appointments, referrals, scripts, medications, med orders, and creation and maintenance of MAR, and other medical related services for individuals as needed. When needed the Medical Direct Support Professional may need to stay with individuals staying home from program due to medical needs.

Medical Direct Support Professional Duties and Responsibilities:

Medical Records:

  • Responds to requests for files from providers.
  • Sends/receives files from other providers as requested, always following HIPAA protocols.
  • Performs clerical duties as requested pertaining to medical record releases.
  • Assist in completing medical appointments and follow ups
  • Assisting and completing referral packets medical related services for individuals on caseload
  • Assist in receiving, maintaining, and entering script information into agency software program
  • Assist in ordering and collecting necessary information towards individuals' medical needs
  • Assist in the maintenance of MARS
  • Assist in ordering medications and ensuring medications are up to date at sites

Prior Authorizations:

  • Efficiently obtain all authorizations for procedures to be performed, prior to patients scheduled date of service including, but not limited to consent.
  • Notify scheduling staff of delays in obtaining required authorizations.
  • Inform supervisor about any changes or patterns they are seeing in denials of procedures.

Referrals:

  • Maintains the computerized managed care system log and maintains electronic files
  • Collaborates with the primary care provider to resolve issues related to specialist availability and patient needs.
  • Files all completed referral forms in the patient's electronic files.
  • Maintains a system for easy access to individual appointments, visit, follow up, and medical treatments and ensure this information is shared with house manager and staff.
  • Completes follow-up with hospitals with regard to submitting orders and any other related documentation (financial or clinical) related to individual medical services
  • Functions as a resource of information and problem solving for individuals, primary care providers, managed care program staff, specialists and health center staff.
  • Maintains up-to-date knowledge of insurance company requirements, communicating changes to colleagues and peers.
  • Attends appropriate meetings to maintain up to date knowledge of individuals medical needs.
  • Maintains documentation to meet audit requirements and participates in audit activities as requested.
  • All other duties as assigned.

Competencies: To perform the job successfully, an individual should demonstrate the following competencies:

  • Strong ability to multi-task
  • Maintains patient confidentiality
  • Professional demeanor and appearance
  • Strong time management & prioritization skills
  • Customer service - manages difficult or emotional individual situations
  • Responds promptly to individual needs.
  • Solicits feedback to improve service delivery
  • Responds to requests for service and assistance.
  • Meets commitments and is punctual.
  • Follows policies and procedures.
  • Completes administrative tasks correctly and on time.
  • Supports organization's goals and values.
  • Flexible and willing to cover whichever tasks are most urgent based on changes in workload and staffing.
  • Clear communication amongst team to facilitate patient needs and care.

Essential Skills and Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • High School Diploma or GED required.
  • Good standing NYS- License
  • At least one year of experience with OPWDD
  • Experience with medical terminology required.
  • Strong organizational, judgment, communication and analytical skills.
  • Ability to multi-task and perform multiple priorities.
  • Cooperative and professional behavior toward individuals, peers, providers, third party providers, and management
  • Ability to promote favorable image with individuals, providers, house staff, and general public.
  • Ability to make decisions and solve problems.
  • The ability to contribute in a team environment and/or independently, to provide excellent service.
  • Experienced computer skills and strong comfort with multiple electronic record keeping systems

Job Type: Full-time- Opportunities for growth!

Benefits:

  • Retirement Contribution
  • Dental insurance
  • Health insurance
  • Life insurance
  • Paid time off and holidays
  • Vision insurance

Schedule: Mon-Fri 10a-6p

COVID-19 considerations: All CDC guidelines are followed

The Alternative Living Group, Inc.
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