A Career in Healthcare Management - Who Does What in a Medical Office?

These descriptions will not perfectly fit all practices,- Reviews orders written by providers and
this is just a generalization. Each practice dividesdetermines where test and procedures may be
duties based on the number and skills of the staff inperformed based on patient's insurance
their office, and the providers' specialties. These- May provide the patient with information about the
descriptions should help to define what the basictest or procedure cost and what the patient's
tasks are in most practices.financial responsibility is estimated to be
Front Desk/Check-In - Usually the first person you- Pre-authorizes, pre-certifies, or pre-notifies the test
meet in a medical practice, this person sets the toneor procedure if required by the patient's insurance
for the practice by the way she greets you andcompany
makes you feel expected and welcome- Schedules the test or procedure
- Greets patients and visitors to the practice- Provides the patient with information about
- Registers patients in the practice managementpreparation for the test or procedure
system which may mean entering information givenLab Technologist/ Phlebotomist - lab employees must
verbally or on registration formsbe quality-minded and must inspire confidence in
- Collects identification and insurance cards and copiespatients that they will not be hurt while taking blood,
or scans them for the record, may photograph theor be stuck unnecessarily.
patient for the record- Receives laboratory requisitions from provider and
- May collect co-pays or other moniescollects specimens according to provider order
- Prints encounter form (also called superbill, routing- Provides Medicare patients with an Advance
slip, or fee ticket) with updated information, orBeneficiary Notice if any lab test or procedure to be
updates information on the encounter formperformed in the office will not be covered by
- Has patient sign financial agreement, receipt ofMedicare
privacy policy, benefits assignment, etc.- Performs tests or packages specimens to be
- May answer phone calls, take messages and maketransported to reference lab
appointments- Receives results back from the labs and matches
- Directs visitor (drug reps, salespersons, etc.)them to charts
appropriately- Performs lab controls daily and checks and records
Medical Records - although medical records positionstemperatures on lab refrigerators and freezers
are often entry-level positions in a medical office, aCheck-out Desk - a firm, yet pleasant person at the
practice lives and dies by its medical recordscheck-out desk is important to ensure that
management, which needs to be as close to perfectover-the-counter collections are maximized.
as possible.- Reviews services received by patients, checking to
- Primary responsibility for the integrity andmake sure that all services received were checked
management of the medical record, whether paperon the encounter form
or electronic- Enters charges in the computer system for services
- Controls record filing (paper) or indexing (electronic)received
- Fulfills requests by patients, attorneys, insurance- Tells patient if any additional monies are owed if
companies, and social security for release of recordsco-pay was collected at check-in
- May manage paper faxes and messages by- May sign patient on to a payment plan if needed
attaching to charts and delivering to provider- Takes monies owed, posts monies and produces a
- May prepare paper charts for chart audits byreceipt for the patient
payers or others- Makes return appointment for the patient if
- May be the HIPAA Officerneeded, or enters recall into the practice
Medical Assistant, LPN or RN - typically the personmanagement system
who escorts patients from the waiting area to theBiller or Collector - these employees are the bulldogs
exam rooms, this person must be friendly and inspireof the industry and easily manage the day-to-day
confidence in the patients.changes of the insurance plans that make getting
- May assist Physician, Nurse Practitioner or Physicianreimbursed an art.
Assistant with procedures- Corrects claims that are rejected from the claims
- Depending on state laws, may give injectionsscrubber, clearinghouse or payer
- May perform procedures independently (ear wax- Files secondary and tertiary claims as needed,
removal, staple removal, etc.)electronically or via paper
- Provides Medicare patients with an Advance- Posts receipts from insurance companies and
Beneficiary Notice if any lab test or procedure to bepatients and edits any electronic remittance advice;
performed in the office will not be covered bymay post from lockbox account on the web
Medicare- May prepare deposits and/or make deposits
- May perform phlebotomy (draw blood)- Generates patient statements
- May collect specimens, perform basic laboratory- May check eligibility on patients with appointments
tests and chart resultsand call patients whose insurance is not active (*may
- Provides patient education verbally and by providingbe delegated to a financial counselor if this position
written materialsexists)
- May schedule tests or procedures ordered by the- Calls patients who have not made payments in
providerresponse to statements
- May schedule surgery and prepare surgery packets- May turn patients over to third-party collectors
for providers (*this may be delegated to a surgery- Takes phone calls from payers or patients about
scheduler if this position exists)billing issues and resolves issues
- Calls patients about test or procedure results;Coder - this person must have an excellent grasp of
returns patients calls with answers after consultinganatomy, physiology and medical terminology to
with providermake sure that every service that is performed is
- Prepares exam room for procedures (PAP smears,reflected correctly in the codes.
excisions, etc.), marks specimens for lab and- Reviews notes from inpatient or outpatient
pathologyencounters and codes them according to the
- Cleans exam room after each patient and stocksdocumentation
exam and procedure rooms with supplies- May post charges for services rendered
- May be responsible for ordering office medications- Audits chart documentation for quality purposes to
and medical suppliesensure that provider coding and documentation is
- May perform lab controls daily and check andsynchronous
record temperatures on lab refrigerators and- Introduces changes in procedure (HCPCS) and
freezersdiagnosis (ICD-9) codes and educates staff on the
Triage Nurse - the triage nurse must have a wealthuse of new codes
of nursing knowledge at her command as well as an- Ensures encounter forms and practice management
intuitive sense of when a patient needs to be seen insoftware is updated appropriately with new and
the office, and when they do not.deleted codes
- Takes incoming calls from patients and gives them- May be delegated the Compliance Officer
medical advice according to predetermined nursingBilling Supervisor - this person can do every task
protocolsrequired in the department and may need to as
- Makes decisions about patients needing to be seenvolumes fluctuate from month to month. A fine
urgently, same day or next dayinvestigative and deductive mind is needed.
- May be delegated callbacks from providers or other- Reviews the work of coders, billers and collectors
nursesand performs quality audits to benchmark acceptable
- May see walk-in patients and triage their conditionerror rates
Lead Nurse, Charge Nurse, or Nurse Supervisor - this- Prepares or reviews deposits and tracks daily
person must have the respect and trust of thecharge, collection, write-off and deposit information,
physicians as well as the other clinical staff, and iswatching for monthly aberrations by payer or date
relied upon to make good decisions in the case of a- Reviews Accounts Receivable (A/R) reports,
medical or other emergency.looking for trending or specific problems to be
- Assigns clinical staff specific responsibilitiesaddressed with staff or payers
- Manages clinical staff schedules, using agency or- Brings to the attention of the Office Manager or
temporary staff as neededAdministrator any issues with non-standard payment
- Performs annual competency exams on stafftrends, denials or non-covered services.
- Ensures all staff are current on licenses, continuing- Performs evaluations for billing department staff
education and CPR- Takes escalated patient complaints
- Problem-solves patient issues- May credential providers with new payers or
- May be responsible for ordering office medicationsrecredential providers with payers or hospitals
and medical suppliesOffice Manager, Practice Administrator, or Practice
- Has responsibility for medication sample closetManager - this is the top position in most private
upkeeppractices and may report to a managing physician or
- May perform annual evaluations fro clinical staffthe physician board. In hospital-owned practices, this
- Responsible for equipment maintenance and makesperson reports to a Vice President of Clinics, or the
recommendations for medical equipment as neededCOO or CEO.
- May be the Patient Safety Officer and the- Performs all human resource functions for the
Worker's Compensation Coordinatorpractice
Referral Clerk - this person must have excellent- Has ultimate responsibility for all money flowing in
organizational skills and must be detail-oriented toand out of the practice - makes deposits, pays bills,
ensure that each patient receives the referral neededetc.
and that it will be covered by their insurance plan.