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BusinessOperations - Member Risk Adjustment Coordinator I - 210929

Role overview

Qualifications

  • 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

Responsibilities

  • Schedule appointments and gather medical histories
  • Retrieve charts from electronic medical record systems
  • Request medical records by making outbound phone calls to provider groups
  • Resolve outstanding vendor pends timely

Key facts

Hard skills

Other skills

  • Customer Service
  • Microsoft Excel

About the company

Mindlance logo

Mindlance

Staffing & Recruiting

Founded in 1999, Mindlance is one of the largest diversity-owned staffing firms in the US and has been on SIA’s list of Fastest Growing US Staffing Firms for 10 years. Mindlance has also been recognized as one of the consistently best performing partners to industry-leading MSP programs including Allegis, Kelly, TAPFIN, PROUnlimited, Pontoon, GRI, WorkforceLogiq and Agile-1.What started with contingent staffing has developed to a comprehensive portfolio of workforce solutions. Along with industry specific, talent-centric staffing across a range of specializations- Technology, Engineering, Scientific, Clinical Research, Digital, Creative, Marketing, Profession, Mindlance provides Managed Recruitment services- RPO and Direct + Diverse Sourcing, and Pay+ Services- EoR/Payroll, IC Compliance and AoR.Mindlance is also generating alternative talent pipelines that prioritize diversity through three Diverse Talent Acceleration offerings: (1) RebootTalent, a diverse returning talent acceleration service (2) Mindlance Diversphere, a private diverse talent pool aggregated from a network of diversity partnerships and (3) Quintrix Solutions, an upskilling recruit-train-deploy service.With a year-over-year growth rate of 20% and an annual revenue of over $400 million and growing, the Mindlance story is one of calculable achievement, made meaningful by the commitment to grow a mindful way that creates balance in the work and societal ecosystem.Visit www.mindlance.com to learn more about us and our latest job openings.STAFFING INDUSTRY ANALYSTS RECOGNITIONS:Fastest Growing U.S. Staffing Firms (2022, 2021, 2019, 2018, 2017, 2016, 2015, 2014, 2013, 2012, 2011)Largest U.S. Staffing Firms (2022, 2021, 2020, 2019, 2018, 2017, 2016, 2015)Largest Diversity-Owned U.S. Staffing Firms (2022, 2021, 2020, 2019, 2018, 2017, 2016, 2015)Largest IT Staffing Firms (2022, 2021, 2020, 2019, 2018, 2017)Largest Clinical & Scientific Staffing Firms (2022, 2021, 2020, 2019, 2018, 2017)

Company details

Company typeLarge
IndustryStaffing & Recruiting
Company size1001 - 5000

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Job description

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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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?
Collecting medical records for the Ambetter risk adjustment project via EMRs.


New project.

5 FTEs all working remotely. The team is comprised of independent thinkers. The culture follows Centene values built on collaboration and accountability.


No additional hiring needs this year. 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?
Day to day working in a shared tracker for daily assignment and pulling medical records from EMRs.




During ramp up time 10 medical records/hr must be retrieved.

It has direct impact on member care. Candidate Requirements Education/Certification Required: HS diploma/GED Preferred: Licensure Required: Preferred: Years of experience required: at least 2 years Risk experience

Disqualifiers: No EMR experience

Additional qualities to look for: EMR experience, Microsoft experience, HEDIS
  • Top 3 must-have hard skills stack-ranked by importance
1 Organization skills 2 Independent worker 3 Risk medical records retrieval experience 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 computers skills test- Excel beginner Next Steps
  • Do you have any upcoming PTO?
Calendars UTD
  • Colleagues to cc/delegate
Julie Olsen/ Stacey Bird

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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