1. Perform research to identify vendors in various markets
2. Coordinate with Call Center and Vendor regarding event dates
3. Coordinate with PSU (practice support unit) on resource requests
4. Develop reporting package for individual events to gauge success
5. Develop action plan and metrics to measure event success
6. Auditing support for PSU and/or data miners (validation of PRP open/closed gaps)
7. Use ePRG to pull various reports including but not limited to PML, Pink Box, Patient Summary detail, etc.
8. Troubleshooting for missing elements (i.e. may include calling radiology providers for copies of mammogram reports)
9. Assist PSR as necessary with outbound calls
10. Preparation of visit checklist and packets for MA/NP visits (including preparing packet of SDS, FOC, Attestation, and Patient Summary Detail log)
11. Responsible for ensuring all Resource Requests are sourced and staffed appropriately
12. Coordinate with mobile screening vendor(s) for completion of FOC
13. Create any member mailings or customized calling scripts that are necessary to support QRA PSU efforts
14. Conduct post audits and ensure all gap measure were capture by corporate team (e.g. no longer pink in pink box)
15. Ensure direct manager has accurate knowledge of progress, risks, and barriers proactively.
16. Identify training opportunities for staff based on post audits and report findings to direct manager.
Must have qualifications/experience:
- High school graduate or GED required.
- Two years of healthcare related experience
- 2 years or more experience working with Microsoft Office – Excel, word, etc.
- Working knowledge of medical office procedures and medical terminology.
- Ability to accurately sort and file materials by alphabetic or numeric systems
- Effective communication and customer service skills required.
- Be flexible and adaptable to change.
- Current Driver’s License and reliable transportation with ability to travel to provider offices.
- Ability to exercise sound judgment in the handling of complex inquiries per protocol
- Ability to work effectively in a fast paced healthcare driven environment
- Ability to adhere to daily schedules and duties
- Ability to think critically
- Ability to effectively de-escalate and resolve issues
- Excellent listening skills
- Excellent Customer Service voice and demeanor
- Excellent telephone etiquette
- Excellent oral and written communication skills
- Excellent problem solving skills
- Excellent demonstration of caring and compassion
- Strong computer experience (data entry, screen navigation, keyboarding)
- Strong desire to work with the elderly
Preferred Education, Experience & Skills
- Associates Degree in healthcare with medical office experience
- Experience with Vendors
- 1 year of Managed Care Experience preferred.
- ICD 9/10 and CPT coding experience preferred.
- Bilingual (English/Spanish) preferred.
Physical & Mental Requirements: (check all that apply)
- Ability to lift up to 50 pounds
- Ability to push or pull heavy objects using up to 50 pounds of force
- Ability to stand for extended periods of time
- Ability to use fine motor skills to operate equipment and/or machinery
- Ability to properly drive and operate a company vehicle
- Ability to receive and comprehend instructions verbally and/or in writing
- Ability to use logical reasoning for simple and complex problem solving
- Occasionally requires exposure to communicable diseases or bodily fluids