BusinessOperations - Member Risk Adjustment Coordinator I - 210929

Mindlance

🇺🇸 United States

Remote

Manager or above

1 week ago

Excel
EMR
HEDIS

1 week ago

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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

BusinessOperations - Member Risk Adjustment Coordinator I - 210929 · Mindlance

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