Quality and Risk Specialist - Healthcare Insurance
$40,560–$40,560 year
On-siteCalifornia, United States or Visalia, California, United States
Job Summary
Make outbound calls to members to support quality improvement initiatives and answer inbound calls from members and healthcare providers, routing calls and taking messages. Review, update, and maintain Electronic Medical Records (EMRs) and member charts, then document completed quality measures within the COZEVA system. Maintain accurate member records and departmental documentation while assisting with reports, Provider Assessment Forms (PAF), workflow tracking, and administrative projects. Collaborate with internal departments and external healthcare partners to provide general administrative support and assist with special projects as assigned. Cross-train and provide coverage for other departmental functions when needed. This role supports the Quality & Risk department within a growing healthcare organization in Visalia, CA.
Required Qualifications
- High School Diploma or GED
- Minimum of one (1) year of experience in a healthcare, medical office, or administrative environment
- Proficient with Microsoft Office
- Ability to prioritize multiple tasks and meet deadlines in a fast-paced environment
- Ability to remain seated for extended periods
- Ability to occasionally lift up to 25 pounds
- Regular attendance
- Occasional overtime, weekends, or holidays
Desired Qualifications
- experience in a healthcare, medical office, or administrative environment
- Experience working with Electronic Medical Records (EMRs)
- Excellent verbal and written communication skills
- Strong customer service and active listening abilities
- Accurate data entry and recordkeeping skills
- Critical thinking and problem-solving abilities
- Ability to work independently and collaboratively within a team
- Adaptable, dependable, and professional
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