Clinic Assistant - CMA

CLINIC ASSISTANT (I, II, III, IV, V)

LOCATION:

All Locations

DEPARTMENT:

Clinical Support

REPORTS TO: Site Manager

SUPERVISES:

None

PAY TYPE:

Hourly; Non-Exempt

DATE:

May 2025

As the Clinic Assistant you will participate in a team approach to patient care, working integratively with others and face-to-face with patients adapting quickly to changing priorities, while maintaining a high level of detail and exemplary customer service. The ultimate design and goal of the Clinic Assistant is to become proficient in all five (5) Clinic Assistant Levels to promote cross-training and create system redundancy for continual quality improvement and back-up coverage. Maintain patient confidentiality and ensure compliance with HIPAA policies and procedures.

ESSENTIAL DUTIES & RESPONSIBILITIES

The employee will be assessed for their strengths upon hire and begin onboarding in one of the following areas: Front Desk, Appointment Scheduling, Pre-Certification, Referral Management, Back Office Support and have competencies signed-off by immediate supervisor and/or COO in the within three months of service from date of employment to be officially classified as a Clinic Assistant 1.

For each additional Clinic Assistant Level achieved the employee will enhance their position as a Clinic Assistant and compensation will be assigned appropriately.

• Clinic Assistant I is the entry level; this may be the Clinic Assistant’s primary scope of responsibilities even as the Clinic Assistant achieves additional levels. If the Clinic Assistant elects to or is unable to achieve additional levels the Clinic Assistant will be documented as being at level I.
• Clinic Assistant II, III, IV, or V will be achieved when the Clinic Assistant I has been signed off on competencies for an additional level such as Front Desk responsibilities, Appointment Scheduling responsibilities, Pre-Certification responsibilities, Referral responsibilities and/or Medical Assistant Back Office Support responsibilities.
• The ultimate design and goal of the Clinic Assistant is to become proficient in all five (5) Clinic Assistant Levels to promote cross-training and create system redundancy for continual quality improvement and back-up coverage. To achieve and maintain the compensation awarded per each level, the expectation will be for the Clinic Assistant to remain adaptable and willing to be flexible working any area of responsibility achieved per the need of Neighborhood Health.

Front Desk Responsibilities

• Welcomes patients and visitors by greeting patients and visitors, in-person or on the telephone in a professional, courteous, and efficient manner

• Collect co-pays as indicated

• Calculate income for Sliding Fee Scale

• Maintain patient flow; keeps patient appointments on schedule by notifying provider of patient’s arrival, reviewing service delivery compared to schedule, reminding provider of service delays

• Comforts patients by anticipating patient’s anxieties, answering patient’s questions

• Provide Check-out Support and schedule return appointments

• Maintain current demographics and insurance information at each visit

• Review any eligibility issues on all patients prior to visit

• Assist with scanning and indexing of medical documents

• Maintain confidentiality of patient’s private protected medical information

• Helps patients in distress by responding to emergencies

• Maintains front desk inventory and equipment by checking stock to determine inventory level; anticipating needed supplies

• Masters the ability to identify and assign correct insurance on patient accounts including subscriber information required for proper billing

• Establish Competency eClinical Works (eCW) Check Off Learning Modules and understand the importance of gathering all information needed to complete patient registration: usual provider, guarantor, insurance cards, driver’s license

• Master eCW Workflow to Check Out patients, Schedule New & Recheck, Print Patient Summaries, Labs, Appt. Reminders, and Patient Instructions

• Initiate and Update HIPAA Forms

• Run Self Pay Checklist and Medicaid Eligibility, apply information to the patient account & route verification to billing team

• Perform opening and Closing Reception Service duties

• Coordinate with the Triage Nurse, urgent emergent patient walk-in appointments

• Coordinate customer services for patients arriving late by collaborating with the Triage Nurse and Provider

• Reconcile Daily money collected

Appointment Scheduling Responsibilities:

• Answer all incoming calls in a professional, courteous, and efficient manner
• Schedule appointments according to NH policy and protocols specific for the following: Well Child Checks, Adult Well Exam, Dermatology Clinic, Float Nurse, OB Check, OMT Manipulation, Urgent Care/Same Day, Social Work, & Linked Visits
• Answers general questions, schedules, screens, and route outside calls to correct extension
• Endeavor whenever possible to schedule patients with their own primary physician or to the appropriate team
• Reschedule clinic schedule as requested by Clinical Manager or COO, notify appropriate departments prn
• Run eligibility inquiry on all patients prior to scheduling
• Work in coordination with the Health Care Workers for all self-pay patients
• Take detailed messages via email from caller when voicemail is not an option.
• Initiate calls to patients to reschedule or fill gaps
• Assist with Call Center Monthly Campaigns
• Work Reports to support closing Care Gaps
• Manage Calls with the Support of Language Services.

Pre-Certification Responsibilities

• Obtains precertification, prior approval, or pre-determination authorization for medications, procedures/tests, services, medical supplies and durable medical equipment ordered by physician; request authorization for services and DME (durable medical equipment) as needed.
• Contacts patient’s insurance company, including workman’s compensation carriers, for eligibility, pre-existing, or exclusions; provides patient’s medical history, treatments received, current conditions, and planned testing or surgical treatment.
• Determines if prior approval is needed and notifies the appropriate department staff of outcome and the patient when necessary; in doing so either contacts insurance company by phone, fax or completes documentation via online computer form with pertinent information including patient history, diagnosis, and current symptoms.
• Contact patient to resolve any issues that occur during the verification process prior to their visit.
• Assists in answering patient questions when they present regarding insurance coverage for a procedure.
• Notifies appropriate staff of any possible problems in payment for a procedure, i.e. no insurance or noncovered procedures or services.
• Documents in the computer system the precertification, prior approval or pre-determination authorization information from the insurance company.
• Merge lab results
• Daily checks the schedule for possible add on patients that had not been previously approved through the precertification, prior approval, or predetermination process.
• Obtain records for patient encounters (i.e. hospitals, specialty offices, etc.), as needed
• Interacts with physicians, nurses, coders, and other Clinic staff to gather patient information needed for precertification, prior approval, or pre-determination process.
• Performs basic clerical duties including photocopying, sorting and indexing of reports.
• Updates patient demographics if inaccuracies are found.
• Prioritize urgent requests.
• Obtain a retrospective review on those services where prior authorizations were not obtained.
• Document in eCW all information provided by the insurance representative.
• Document completion of tasks in eCW.
• Notify patient when authorization has been obtained/denied.
• Notify pharmacies, hospitals, DME providers, and vendors when authorization has obtained/denied.
• Communicate any changes in pre-certification requirements to relevant staff.
• Collaborate with staff on referral needs and payer requirements.
• Seeks guidance from licensed staff when needed.

Patient Care Coordinator Responsibilities

• Run eligibility reports on all patients
• Participates in contacting patients prior to office visits to ensure appropriate information is on chart and to clarify reason for appointment
• Obtain records for patient encounters (i.e., hospitals, specialty offices, etc.), as needed
• Tracks On Call to ensure patients are getting timely medical advice while clinic is closed
• Checks recent ER patients through hospital system, determine if they are patients and if so, contact for follow up
• Schedule referral appointments for testing, specialty physicians, outpatient needs, and any other scheduling as determined by the physician during the office visit
• Work referral bucket of eCW for new referrals and those not scheduled live with patient, send messages to the physician as needed for clarification & follow up on messages regarding referrals
• Track referrals, labs, and radiology reports
• Track preventative and chronic care measures
• Schedule for PT, OT, Speech Therapy, Home Health, or Dietitian/Nutritionist
• Performs basic clerical duties including photocopying, sorting, and filing of reports
• Updates patient demographics if inaccuracies are found
• Prioritize urgent requests
• Document completion of tasks in eCW
• Collaborate with staff on referral needs and payer requirements
• Complete referral paperwork/forms as required by refer to physician offices/specialty clinics. Then join the forms with eCW documentation as needed. Send via eCW fax/outside fax as required.
• Seeks guidance from licensed staff when needed
• Discharge patient via eCW and or assist with appointment check in during peak times

Medical Assistant (Back Office/Rooming Patients and developing skills to provide Primary Support Assignments) Responsibilities

• Inspect patient’s EMR to ensure completeness prior to appointment; make sure problem lists, medication lists and recent hospital and specialist visits are on the chart
• Escort patient to exam room, interviews patient, measures vital signs such as weight, blood pressure, pulse, temperature, and documents all information in patient’s chart within required timeframe
• Assist physician in exam room as needed
• Provide instructions to patient as instructed by physician
• Ensure all related reports, labs, and information is filed and available in patient’s medical records prior to appointment
• Keep exam rooms stocked with adequate medical supplies, maintain instruments, prepare sterilization as required
• Anticipates physician’s needs, prepares patient appropriately for appointment; works on floor and assist licensed staff; assures patient flow is efficient
• Tracks All Call to ensure patients are getting timely medical advice while clinic is closed
• Tracks referrals, labs and radiology reports
• Participates in contacting patients prior to office visit to ensure appropriate information is on chart and to clarify reason for appointment; run eligibility reports on Medicaid patients
• Assist with scheduling referral appointments for testing, specialty physicians, outpatient needs, and any other scheduling as determined by the physician
• Assist with resulting labs as designated by Clinical Leadership Team
• Maintains current information and knowledge base, especially around immunizations

Medical Assistant (Medication Administration)

• Seeks guidance from licenses staff as needed
• Assures excellence in resident education by reporting any potential deficiencies or problems to the staff physician, Clinical Manager, or COO.

General Responsibilities for all levels of a Clinic Assistant (I, II, III, IV, and V)

• Communicates effectively and respectfully with all patients, support staff, residents, and faculty
• Maintains confidentiality and HIPAA of all patient information
• Obtains and keeps CPR certification up to date
• Attends all staff meetings, in-services and other meetings as required
• Participates in cross-training to create system redundancy for continual quality improvement and back-up coverage
• Adhere to ethical business practices by striving to perform in a manner that conforms to the highest standards of ethical behavior, integrity and honesty; exhibits commitment and promotes NHC’s mission, values and vision
• Takes initiative and responsibility for decisions as an individual and as an staff member of NHC; encourage a positive work environment and experience for co-workers, patients, faculty, physicians, and residents
• Adhere to all organizational and departmental policies, procedures and practices; maintain proper attendance and punctuality
• Utilize material, equipment and time in a safe, beneficial and cost-effective manner; organize workload to complete responsibilities in an appropriate and timely manner
• Performs other appropriate duties and activities incidental to the work and responsibilities commensurate with this position as assigned by the office manager and/or COO.

REQUIRED SKILLS / ABILITIES

• Clinical-demonstrates a working knowledge and skill in the clinical support process (assessment, planning, implementation, and evaluation); maintains knowledge of, and acts in accordance with, current NHC policies and procedures.
• Business Management-demonstrates a comprehensive understanding of the administrative (operations, HR, finance) and clinical systems required for a community health center to be successful in its mission.
• Organizational Development-demonstrates the ability to think strategically, anticipate future consequences and trends, and incorporate them into the organizational plan.
• Problem solving—identifies and resolves problems in a timely manner and gathers and analyzes information skillfully.
• Interpersonal skills—maintains confidentiality, remains open to others’ ideas and exhibits willingness to try new things; maintains friendly and supportive relationships with coworkers; talks through problems to keep channels of communication open and maintain a high level of trust; realizes the importance of, and practices, good customer service; and able to communicate effectively with people of varying cultures, socio-economic backgrounds, languages, and educational levels.
• Oral communication—speaks clearly and persuasively in positive or negative situations, demonstrates group presentation skills.
• Written communication—edits work for spelling and grammar, presents numerical data effectively and is able to read and interpret written information.
• Planning/organizing—prioritizes and plans work activities, uses time efficiently
• Quality control—understands the importance of compliance standards and pays close attention to accuracy and detail when performing duties; demonstrates a working knowledge of how grant requirements and federal/state laws impact the day-to-day operations of NH’s financial department.
• Adaptability—adapts to changes in the work environment, manages competing demands and is able to deal with frequent change, delays or unexpected events.
• Dependability—consistently at work and on time, follows instructions, responds to management direction and solicits feedback to improve performance.
• Safety and security—actively promotes and personally observes safety and security procedures, and uses equipment and materials properly.

REQUIRED QUALIFICATIONS:

Education / Training

High School Diploma/GED. Training in medical and/or dental office and billing procedures. Associate’s degree in medical assisting or certification as a dental office specialist preferred.

Experience

Minimum of one year experience in patient care/medical office ideal, not required. Word processing and computer experience preferred. Knowledge of medical terminology and coding preferred. Experience with medical office software program preferred.

Licensure/Certification

CPR Certified. Certified Medical Assistant.

Physical Requirements

Prolonged standing and walking, some stooping, bending, and stretching. Requires full range of body motion, manual dexterity, and eye-hand coordination sufficient to handle and assist patients. Requires ability to lift and carry items weighing up to 50 lbs. Requires corrected vision and hearing to normal range to record, prepare, and communicate appropriate reports. Requires ability to work under stressful conditions. Requires exposure to communicable diseases and bodily fluids.

Work Environment

Normal medical office environment. Work may involve irregular hours, including evenings or weekends. Involves frequent contact with other staff, physician’s offices, patients, and the public. Contact may involve dealing with sick, angry, or upset people. Frequent exposure to communicable diseases, toxic substances, medicinal preparations, and other conditions common to a clinic environment. OSHA Category I – Tasks involve contact with blood or body substances.