BusinessOperations - Member Risk Adjustment Coordinator I - 210929

Candidate Requirements Required: High School Diploma/GED Preferred: Associate degree Required: N/A Preferred: Years of experience required: 1-2 healthcare knowledge, medical charts, contacting providers for chart retrieval. Disqualifiers: Additional qualities to look for: Experience Excel, EMR systems (EPIC, Athena, Healow, etc) Top 3 must-have hard skills stack-ranked by importance.

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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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.
Story Behind the Need
This team is responsible for supporting providers in all areas of Risk Adjustment. Part of the work is for retrieving medical charts and supporting our vendor partners with the retrieval. This resource would be helping with the latter. This is a backfill for an FTE The team consists of resources with risk adjustment expertise, and familiarity with EMR systems. Part of the role will be interacting with provider offices in facilitating chart retrieval. The resource will mainly be working independently, though will always have an escalation path if needed.
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?	There are several chart retrieval campaigns the team is required to support. Two of these campaigns are annual for Medicare and Marketplace charts respectively. We are also involved in supporting chart retrieval for federal audits where timing of retrieval is more important. Performance expectations include handling escalations from our vendor parters in situations where they cannot retrieve charts from specific providers for various reasons. All escalations are expected to be acted upon with research to locate the correct provider resource/office to handle the chart request. This role is unique with the provider interaction, working with our vendor partners, and the use of EMR systems.
Candidate Requirements
Required: High School Diploma/GED			Preferred: Associate degree
Required: N/A			Preferred:
Years of experience required: 1-2 healthcare knowledge, medical charts, contacting providers for chart retrieval. Disqualifiers: Additional qualities to look for: Experience Excel, EMR systems (EPIC, Athena, Healow, etc)
Top 3 must-have hard skills stack-ranked by importance	1	Excel
	2	Communication (Requesting medical charts from provider offices), communicating status to internal resources and vendor partners.
	3	Organization
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- Cameras On
	Required Testing or Assessment (by Vendor):			Basic Excel