Even with computerized appointment programs and electronic billing, Maria DiGrigoli manages much more paperwork than she had to when she started working as a medical administrative assistant 27 years ago. So why does she stick with this profession?
“I love helping people and working with doctors,” says DiGrigoli, office manager at Cedar Bridge Medical Associates, a six-physician family practice in Bricktown, New Jersey.
The very mention of referrals, precertification, medical records privacy and malpractice insurance renewals may raise fears in MBAs, lawyers and accountants. Yet all of these issues are now everyday challenges for the medical admin, who stubbornly battles bureaucracy on behalf of both doctors and patients.
Whether in a small practice or a large hospital, today's medical admin is the glue that holds a medical office together.
When Beverly Stringer started as a unit clerk in a women's health center 20 years ago, the most advanced technology tool she used was the telephone. All patient testing was ordered on handwritten forms that were hand-carried to the hospital lab or radiology department.
“There were days when I thought I ought to have been paid mileage,” Stringer says.
Today, these forms are sent via modem, and doctors may view X-rays on their computer screens. A sophisticated automated telephone system sorts routine calls away from Stringer, who is now an administrative secretary for the community relations department at Southern Ohio Medical Center in Portsmouth, Ohio.
The Growing Complexity of Insurance
On the downside, with the rise of managed care, myriad available insurance plans have prompted the need for admins to keep up with an ever-changing maze of rules and procedures. Investigating the reasons behind an unpaid bill may be a task worthy of Sherlock Holmes's expertise.
Another big challenge for medical admins right now is complying with the Health Insurance Portability and Accountability Act (HIPAA), which specifies strict new guidelines for maintaining the confidentiality of medical information.
“Everybody is afraid of doing something wrong,” DiGrigoli says.
A Variety of Roles
At a smaller medical office, an admin may be a jack-of-all-trades, handling everything from appointments to insurance issues. At hospitals, clinics and larger practices, though, the admin's role may be significantly more specialized. The complexity of handling insurance issues has necessitated the use of separate departments for precertification, coding and billing.
Some medical admins work for specific units. For example, Carlotta Embry has few dealings with patients and seldom handles insurance issues. As the assistant to the director of perioperative (presurgical, surgical and postsurgical) services at Saint Joseph's Hospital of Atlanta, her tasks include updating department policies and procedures; coordinating payroll, time and attendance; editing and publishing the department newsletter; ensuring compliance with hospital-wide infection control, safety and age-specific guidelines; and supporting a diverse range of other perioperative staff.
Prior to taking this position, Embry had never worked for a large medical institution. Her advice to admins seeking employment in healthcare is to present their core competencies, such as customer service, organizational skills, time management, software knowledge and communication, to prospective employers.
"Flexibility and willingness to learn is paramount in the OR setting," Embry says.
A Budding Field in a Stifling Economy
An increasing workload is requiring medical institutions to add more staff, DiGrigoli says. Having some experience with software and insurance is desirable in a medical admin candidate, but DiGrigoli says she is willing to train someone with savvy telephone skills and an enthusiasm and aptitude for learning.
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