Care Coordinator - Medicare Advantage
We are looking for highly motivated individuals to join our ever growing team here at BinghamYou must be willing and able to learn new skills and adapt to change often, as the medical field is ever changingYou must have good communication skills and be detail orientedWe have multiple providers of all specialties and are located in several of our surrounding areasIf you are looking for a rewarding and fulfilling career and enjoy fast paced environments this will be a good fit for youJOB REQUIREMENTS Minimum Education:
High School Diploma or equivalentAssociates or Bachelor's degree in business related field preferredMinimum Work
Experience:
One (1) years' experience in hospital billing preferredPrevious experience in pre-certification and prior authorizations in a hospital setting highly preferredRequired Skills, Knowledge, and Abilities:
Excellent verbal communication skills, computer skills and ability to multitaskMust be able to use Microsoft Office, Word, and ExcelAdapts to EMRs quicklyGeneral mathematicsThe Care Coordinator - Medicare Advantage position on the Population Health team focuses on helping our Medicare Advantage patientsThis position seeks to help Medicare Advantage patients as well as the clinics that serve these patientsPatient-Facing Duties Contact patients regarding annual wellness visit opportunities Contact patients and other healthcare providers regarding care gaps (cancer screenings, immunizations, lab results, and other information) Help connect patients with services in our health system as well as services in the community Help these patients connect with services on the Population Health team as appropriate (chronic care management, post-acute care management, pharmacological consultations, education, etc.
) Document the closure of care gaps on patients' medical records Other duties as they become applicable Clinic-Facing Duties Be aware of upcoming clinic visits for Medicare patients, and provide the clinics with any needed information or objectives that will aid those visits Help clinics as needed with tracking down needed information for patients Inform clinics of additional resources for high risk patients (resources on the Population Health Team, resources in our health system, community resources, etc.
) Attend primary care clinic huddles as needed to communicate with and serve the primary care clinics Other duties as they become applicable Duties to Third Parties Meet with the commercial insurance payors who administer Medicare Advantage plans; review patient populations, review Bingham's performance, and work with them to help Bingham succeed in managing attributed patientsBecome skilled at navigating the various payor web portals to view patient data and care gap opportunities, and also how to upload evidence that care gaps have been closedHelpful Skills and Experience Below is a list of helpful skills and experiences that a candidate needs to have or will need to acquire in order to succeed in this role:
Consistent, pleasant, and helpful customer service skillsA customer is anyone this position serves, including patients but also including clinics, providers, and anyone else that needs coordination helpMust be professional on the phone and in personSolid team collaboration skills - every day, this position will communicate and collaborate with several people on the Population Health Team and many people across our health systemNot a position for those that like to work soloCommunication skills - can explain things to others simply and clearly, and listen as wellCan be well informed in order to have productive conversations with providersComputer skills - can learn EHR and scheduling software; email, messaging, and video conferencing platforms; and various web portals in order to retrieve patient dataAmple opportunity will be given for learning and orientation, but this role will rely on these computer abilities dailyIntegrity - must be honest, must be reliable, and must take pride in doing good work and providing good serviceAdaptability - the Population Health Team tackles performance and process improvement projects frequentlyMust be open to trying new workflows, and must have an understanding that objectives and responsibilities are more important than the way something has always been done, especially if changes can help us better achieve those objectives and responsibilitiesUnderstanding of value-based care - we help the people that need to go to the hospital, but our aim is to also help other high-risk patients to better control their conditions to prevent the risk they'll need to go to the hospitalWe aim to help people thrive as much as we canOther Abilities Treats patients and their families with respect and dignityIdentifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their familiesFunctions as a liaison between patients, physicians, and other healthcare providersConsults other departments as appropriate for an interdisciplinary approach to patient needsMaintains a good working relationship both within the department and with other departments within the Bingham Healthcare organization and our PartnersDocumentation meets current standards and policiesFlexible and organized, can function well under stressful conditionsCompletes annual education requirements and evaluationsMaintains regulatory requirementsAlways maintain patient confidentialityReports to work on time and as scheduled, completes work within designated timeRepresents the organization in a positive and professional mannerComplies with all organizational policies regarding ethical business practicesMaintain flexibility in a growing environment and be willing to grow, change and accept new duties as the scope of our department changes with the needs of the community and healthcare systemSolid understanding of HCC coding and quality measures of all payorsUnderstands care gap rostersMust have sensitivity, maturity, and ability to communicate clearly and concisely, both verbally and in writingMust be patient, courteous, compassionate, and respectful with patients, their families, coworkers, physicians, and administrative staffAbility to communicate and relate well with physicians, staff, and managementOrganized, detail oriented and has the capacity to manage many patientsParticipates in provider led clinic huddles.
Recommended Skills Adaptability Administration Billing Business Process Improvement Curiosity General Mathematics Apply to this job.
Think you're the perfect candidate? Apply on company site $('.
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open('/interstitial?jobdid=j3w1n16gwmcxdtq6jbn', 'ExternalApply-j3w1n16gwmcxdtq6jbn'); ); Estimated Salary: $20 to $28 per hour based on qualifications.
High School Diploma or equivalentAssociates or Bachelor's degree in business related field preferredMinimum Work
Experience:
One (1) years' experience in hospital billing preferredPrevious experience in pre-certification and prior authorizations in a hospital setting highly preferredRequired Skills, Knowledge, and Abilities:
Excellent verbal communication skills, computer skills and ability to multitaskMust be able to use Microsoft Office, Word, and ExcelAdapts to EMRs quicklyGeneral mathematicsThe Care Coordinator - Medicare Advantage position on the Population Health team focuses on helping our Medicare Advantage patientsThis position seeks to help Medicare Advantage patients as well as the clinics that serve these patientsPatient-Facing Duties Contact patients regarding annual wellness visit opportunities Contact patients and other healthcare providers regarding care gaps (cancer screenings, immunizations, lab results, and other information) Help connect patients with services in our health system as well as services in the community Help these patients connect with services on the Population Health team as appropriate (chronic care management, post-acute care management, pharmacological consultations, education, etc.
) Document the closure of care gaps on patients' medical records Other duties as they become applicable Clinic-Facing Duties Be aware of upcoming clinic visits for Medicare patients, and provide the clinics with any needed information or objectives that will aid those visits Help clinics as needed with tracking down needed information for patients Inform clinics of additional resources for high risk patients (resources on the Population Health Team, resources in our health system, community resources, etc.
) Attend primary care clinic huddles as needed to communicate with and serve the primary care clinics Other duties as they become applicable Duties to Third Parties Meet with the commercial insurance payors who administer Medicare Advantage plans; review patient populations, review Bingham's performance, and work with them to help Bingham succeed in managing attributed patientsBecome skilled at navigating the various payor web portals to view patient data and care gap opportunities, and also how to upload evidence that care gaps have been closedHelpful Skills and Experience Below is a list of helpful skills and experiences that a candidate needs to have or will need to acquire in order to succeed in this role:
Consistent, pleasant, and helpful customer service skillsA customer is anyone this position serves, including patients but also including clinics, providers, and anyone else that needs coordination helpMust be professional on the phone and in personSolid team collaboration skills - every day, this position will communicate and collaborate with several people on the Population Health Team and many people across our health systemNot a position for those that like to work soloCommunication skills - can explain things to others simply and clearly, and listen as wellCan be well informed in order to have productive conversations with providersComputer skills - can learn EHR and scheduling software; email, messaging, and video conferencing platforms; and various web portals in order to retrieve patient dataAmple opportunity will be given for learning and orientation, but this role will rely on these computer abilities dailyIntegrity - must be honest, must be reliable, and must take pride in doing good work and providing good serviceAdaptability - the Population Health Team tackles performance and process improvement projects frequentlyMust be open to trying new workflows, and must have an understanding that objectives and responsibilities are more important than the way something has always been done, especially if changes can help us better achieve those objectives and responsibilitiesUnderstanding of value-based care - we help the people that need to go to the hospital, but our aim is to also help other high-risk patients to better control their conditions to prevent the risk they'll need to go to the hospitalWe aim to help people thrive as much as we canOther Abilities Treats patients and their families with respect and dignityIdentifies and addresses psychosocial, cultural, ethnic, and religious/spiritual needs of patients and their familiesFunctions as a liaison between patients, physicians, and other healthcare providersConsults other departments as appropriate for an interdisciplinary approach to patient needsMaintains a good working relationship both within the department and with other departments within the Bingham Healthcare organization and our PartnersDocumentation meets current standards and policiesFlexible and organized, can function well under stressful conditionsCompletes annual education requirements and evaluationsMaintains regulatory requirementsAlways maintain patient confidentialityReports to work on time and as scheduled, completes work within designated timeRepresents the organization in a positive and professional mannerComplies with all organizational policies regarding ethical business practicesMaintain flexibility in a growing environment and be willing to grow, change and accept new duties as the scope of our department changes with the needs of the community and healthcare systemSolid understanding of HCC coding and quality measures of all payorsUnderstands care gap rostersMust have sensitivity, maturity, and ability to communicate clearly and concisely, both verbally and in writingMust be patient, courteous, compassionate, and respectful with patients, their families, coworkers, physicians, and administrative staffAbility to communicate and relate well with physicians, staff, and managementOrganized, detail oriented and has the capacity to manage many patientsParticipates in provider led clinic huddles.
Recommended Skills Adaptability Administration Billing Business Process Improvement Curiosity General Mathematics Apply to this job.
Think you're the perfect candidate? Apply on company site $('.
external-apply-email-saved').
on('click', function (event) window.
ExternalApply = window.
open('/interstitial?jobdid=j3w1n16gwmcxdtq6jbn', 'ExternalApply-j3w1n16gwmcxdtq6jbn'); ); Estimated Salary: $20 to $28 per hour based on qualifications.
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