Spanish-Speaking Quality Coordinator
On-siteHoliday, 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, Insurance groups, and Billing staff via fax, email, phone, or in person. Check PCP schedules weekly and review charts for outstanding measures, then create or modify HEDIS encounters in patient records. 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 necessary information, and maintain logs of all audit outcomes and document submissions. Report patient information to various health plans through their portals. Requires one year of medical office experience, familiarity with Medicare Advantage plans, and proficiency in medical software such as ECW/Medisoft and MS Office.
Required Qualifications
- High School Diploma or GED
- One year of experience in medical office
- English
- Good clinical skills and physiological knowledge
- Ability to perform comprehensive medical histories and physical exams
- Ability to communication complex medical information to a diverse population
- Ability to work effectively as part of a team
- 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
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