Quality

posted:
Location
Clermont, Florida
Industry
Health & Social Care, Practitioner & Technician (Healthcare Practitioners and Technical Occupations)
Job Type
Temporary
Working Hours
8:00 AM - 5:30 PM
Salary
US$ 27,000 - US$ 30,000 per year
Ref. Number
S_36688
Contact
Perlach,William, Spherion
Phone
352-728-8787
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Job Description

QUALITY COORDINATOR
The primary person to analyze patient chart data to confirm HEDIS measures are being met and addressed appropriately by the Physicians. This person will work closely and communicate with Insurance groups, Physicians, Medical Staff and Billing staff whether it be via fax, email, phone, US mail, or in person. The main objectives is to make sure that HEDIS GAPS are being addressed and communicating with the Physicians, Medical Staff and Senior Management on the status and issues met in their audits.

Responsibilities:
Checking PCP schedules weekly and reviewing patient???s charts for any outstanding HEDIS measures.
Creating or modifying HEDIS ENCOUNTERS in patients??? charts to communicate with Physicians and Medical Staff.
Reviewing or creating various reports using Microsoft Excel. Ability to manipulate spreadsheets using features: filtering, sorting, grouping, etc???
Reviewing/ Updating Member Lists with specific insurance groups and confirming patients have had appointments and creating call lists for those who require visits. Call lists need to be sent to Front Office Managers in each office, with deadline established and lists followed up on in a timely manner.
Assisting with outside chart audits and submitting or required information as needed.
Keeping a log of all chart audits and outcomes of each audit/document submission as needed.
Submitting/reporting patient information to various health plans via their portals as directed.
Perform other duties as may be required.

Working hours: 8:00 AM - 5:30 PM

Skills:
Should possess 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
Be able 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)

Education:
High School

Experience:
1-4 years

Qualifications:
High School Diploma or GED is required
One year of experience in medical office required
Familiars with Medicare Advantage plans and HMO???s preferred
Bilingual in speaking Spanish and English a plus


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All work is performed within a standard health care/primary care clinical setting.

Spherion has helped thousands of people just like you find work happiness! Our experienced staff will listen carefully to your employment needs and then work diligently to match your skills and qualifications to the right job and company. Whether you're looking for temporary, temp-to-perm or direct hire opportunities, no one works harder for you than Spherion. EEO Employer: Race, Religion, Color, National Origin, Citizenship, Sex, Sexual Orientation, Gender Identity, Age, Disability, Ancestry, Veteran Status, Genetic Information, Service in the Uniformed Services or any other classification protected by law.

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