Member Risk Adjustment Coordinator I

at  BCforward

Member Risk Adjustment Coordinator I
BCForward is currently looking for Member Risk Adjustment Coordinator I- Remote
Position Title: Member Risk Adjustment Coordinator I (Remote)
Locations: REMOTE - FL (EST)

JOB DESCRIPTION:

Position Purpose: Schedule appointments, gather medical histories and updated member and provider information in support of member outreach and claims reimbursement.
Collect and process medical records from our providers and coordinate chart collection with vendors. Majority of the day will be customer service-oriented phone outreach to provider groups.
Productivity goals for Pends are 30/10 (at minimum 30 calls per day and 10 calls resolved)
EMR portal access pulls are at minimum a 100 per day.
Employee will meet with IT to ensure the setup of their computer.
Meet with Jennifer Peek (Supervisor) and Jacelyn Pagan (Team Lead)
Work through paperwork required by HR.
Complete Centene University Training
Wrap up meeting with Jacelyn Pagen and Jennifer Peek
Quality Outcomes Coordinator; HEDIS Abstractor; etc.
Medical office experience, HIM experience, medical coding experience, etc.
Required Skills/Experience:
Microsoft Office products (Word, Excel, Teams)
Customer Service etiquette
Time Management
Preferred Skills/ Experience:
Telephone Skills
Fast paced
Multitasking
Computer savvy
Education Requirement: High School
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.

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.

Benefits:
BCforward offers all eligible employees a comprehensive benefits package including, but not limited to major medical, HSA, dental, vision, employer-provided group life, voluntary life insurance, short-term disability, long-term disability, and 401k.About BCforward:
Founded in 1998 on the idea that industry leaders needed a professional service, and workforce management expert, to fuel the development and execution of core business and technology strategies, BCforward is a Black-owned firm providing unique solutions supporting value capture and digital product delivery needs for organizations around the world. Headquartered in Indianapolis, IN with an Offshore Development Center in Hyderabad, India, BCforward’s 6,000 consultants support more than 225 clients globally.
BCforward champions the power of human potential to help companies transform, accelerate, and scale. Guided by our core values of People-Centric, Optimism, Excellence, Diversity, and Accountability, our professionals have helped our clients achieve their strategic goals for more than 25 years. Our strong culture and clear values have enabled BCforward to become a market leader and best in class place to work.
BCforward is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against based on disability.
To learn more about how BCforward collects and uses personal information as part of the recruiting process, view our Privacy Notice and CCPA Addendum. As part of the recruitment process, we may ask for you to disclose and provide us with various categories of personal information, including identifiers, professional information, commercial information, education information, and other related information. BCforward will only use this information to complete the recruitment process.
This posting is not an offer of employment. All applicants applying for positions in the United States must be legally authorized to work in the United States. The submission of intentionally false or fraudulent information in response to this posting may render the applicant ineligible for the position. Any subsequent offer of employment will be considered employment at-will regardless of the anticipated assignment duration.
Interested candidates please send resume in Word format Please reference job code 229224 when responding to this ad.

EXPERIENCE

Not Specified

• 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