Full-Time Quality Improvement Specialist

Job Details

Position Purpose:
Schedule appointments, gather medical histories and updated member and provider information in support of member outreach and claims reimbursement.

Responsibilities:
* 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.

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.