BusinessOperations - Member Risk Adjustment Coordinator I - 210929

Mindlance; United States; Remote; USD 30,000 - 40,000; Full time

Job summary

A healthcare service provider in the United States is seeking a dedicated individual to assist members with scheduling appointments and managing medical records. Ideal candidates will have a high school diploma and some experience in customer service or medical office environments. This position requires effective communication skills and a willingness to engage in a heavy customer service-oriented role. The position is full-time and office-based.

Qualifications

• 0-2 years of customer service or medical office experience.
• Experience with preserved medical record retrieval systems preferred.
• Billing or coding experience preferred.

Responsibilities

• Assist members with scheduling office visits with primary care provider.
• Retrieve charts from electronic medical record systems.
• Request medical records via outbound phone calls.
• Complete supplemental medical records requests using Excel.
• Provide updated member and provider information to vendors.

Skills

Customer service

Medical office experience

Communication skills

Basic Excel skills

Medical record retrieval

Education

High school diploma or equivalent

Job description

Overview

Position Purpose: Schedule appointments, gather medical histories and updated member and provider information in support of member outreach and claims reimbursement.

Education/Experience

High school diploma or equivalent. 0-2+ years of customer service or medical office experience. Experience with preserved medical record retrieval systems preferred. Billing or coding experience preferred. Beginner level Excel skills.

Responsibilities

• Assist members with scheduling office visits with primary care provider.
• Retrieves charts from electronic medical record systems and compile medical records to send to other parties for coding.
• Requests medical records by making outbound phone calls to provider groups.
• Completes supplemental medical records requests using Excel files.
• Assist with providing updated member and provider information to vendors.
• Directs medical record requests to the responsible party.
• Resolves outstanding vendor pends within a timely manner by updating member and provider demographics and working with chart load issues.
• Ensure follow up on member appointments or other tasks designated.
• Assist with ad hoc requests.

EEO

“Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans.”

Day-to-day responsibilities (Walk me through)

• Collect and process medical records from our providers and coordinate chart collection with vendors. Majority of the day will be customer service-oriented phone outreach to provider groups.

Performance expectations / Metrics

• Productivity goals for Pends are 30/10 (at minimum 30 calls per day and 10 calls resolved).
• EMR portal access pulls are at minimum 100 per day.

First day

• Employee will meet with IT to ensure the setup of their computer.
• Meet with Jennifer Peek (Supervisor) and Jacelyn Pagan (Team Lead).
• Work through paperwork required by HR.
• Complete Centene University Training.
• Wrap up meeting with Jacelyn Pagen and Jennifer Peek.

Previous job titles / background

• Quality Outcomes Coordinator; HEDIS Abstractor; etc.
• Medical office experience, HIM experience, medical coding experience, etc.

Team culture

• We are a cohesive team that provides stability.
• We network with our providers and team.
• Provide a professional environment.
• In a remote setting we provide an open-door concept as well as partnerships and team collaboration.

Red flags

• Cannot commit to the 40 hours a week, M – F position.
• Multiple days requested off.
• Not willing to be on a phone for 90% of their day.

Future positions

NO