Referral Coordinator
On-siteMount Dora, Florida, United States
Job Summary
Analyze patient chart data to confirm HEDIS measures are being met and address gaps by communicating with physicians, medical staff, and billing teams via fax, email, phone, or in person. Check PCP schedules weekly, review charts for outstanding measures, and create or modify HEDIS encounters. Review or create reports using Microsoft Excel features like filtering and sorting, while updating member lists and generating call lists for required visits to be sent to Front Office Managers. Assist with outside chart audits, submit information to health plan portals, and maintain logs of audit outcomes. Requires familiarity with Medicare Advantage plans, 2+ years in healthcare, and proficiency in electronic medical record programs.
Required Qualifications
- 2+ years healthcare/primary care experience
- knowledge (electronic medical record programs)
- Ability to communication complex medical information to a diverse population
- Ability to perform comprehensive medical histories and physical exams
- Good organizing, coordination and office skills
- Customer service orientation and good phone etiquettes
- Knowledgeable about record keeping, billing, coding and reimbursement processes
- Computer literate
- knowledge and skill in the operation of computer systems and applications (medical software e.g. ECW/Medisoft and productivity software e.g. MS Office)
Desired Qualifications
- Familiars with Medicare Advantage plans and HMO's preferred
- Spanish speaking ability is preferred
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