BusinessOperations - Member Risk Adjustment Coordinator I - 210929

Candidate Requirements Education/Certification Required: High School Preferred: Licensure Required: Preferred: Years of experience required: Disqualifiers: Additional qualities to look for: Telephone Skills. 1 Microsoft Office products (Word, Excel, Teams) 2 Customer Service etiquette strong phone etiquette 3 Time Management 4 Organized 5 Medical record abstraction Candidate Review & Selection Shortlisting process.

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.

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.

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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.
Story Behind the Need
What is the purpose of this team? What is driving this need? (ex. Backfill for FTE or CW, new project, business growth) Describe the surrounding team (team culture, work environment, etc.) & key projects. Do you have any additional upcoming hiring needs, or is this request part of a larger hiring initiative?		Position Purpose: Schedule appointments, gather medical histories and updated member and provider information in support of member outreach and claims reimbursement. Driving this need: Short term project need " 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 N/A
Typical Day in the Role
Walk me through the day-to-day responsibilities and a description of the project (Outside of the Workday JD). What are performance expectations/metrics? What makes this role unique?			" 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. Productivity goals for Pends are 30/10 (at minimum 30 calls per day and 10 calls resolved); EMR portal access pulls are at minimum a 100 per day.
Candidate Requirements
Education/Certification	Required: High School				Preferred:
Licensure	Required:				Preferred:
Years of experience required: Disqualifiers: Additional qualities to look for: Telephone Skills Fast paced Multitasking time management skills Computer savvy Self-motivator Previous job titles or background that work well in this role? " Quality Outcomes Coordinator; HEDIS Abstractor; etc. " Medical office experience, HIM experience, medical coding experience, etc.
Top 3 must-have hard skills stack-ranked by importance			1	Microsoft Office products (Word, Excel, Teams)
			2	Customer Service etiquette strong phone etiquette
			3	Time Management
			4	Organized
			5	Medical record abstraction
Candidate Review & Selection
Shortlisting process Candidate review & selection Interview information Onboard process and expectations			Projected Manager Candidate Review Date:			1-2 days post shortlisting
			Type of Interviews:			Teams calls with Cameras on
			Required Testing or Assessment (by Vendor):			Typing test, basic computers skills test, etc. N/A
Next Steps
Do you have any upcoming PTO?
Colleagues to cc/delegate