BCForward is looking for Member Risk Adjustment Coordinator I- Remote- FL
Position Title: Member Risk Adjustment Coordinator I
Location: Remote (Florida - Eastern Standard Time Zone)
Anticipated Start Date: ASAP
Expected Duration: 06 months
Job Type: FULL TIME (>%3D40 HRS WEEKLY, [CONTRACT], [REMOTE]
Shift: 8:00 AM - 5:00 PM, Monday to Friday
Pay Range: $22/hr on W2
**Position Purpose:**
The Member Outreach and Claims Support Coordinator is responsible for assisting with appointment scheduling, gathering medical histories, and updating member and provider information to support member outreach efforts and claims reimbursement processes.
**Education/Experience:**
- High school diploma or equivalent required.
- 0-2+ years of customer service or medical office experience preferred.
- Experience with electronic medical record (EMR) systems and preserved medical record retrieval is a plus.
- Billing or coding experience preferred.
- Beginner-level Excel skills required.
**Key Responsibilities:**
- **Appointment Scheduling:** Assist members with scheduling office visits with their primary care providers to ensure timely care and documentation.
- **Medical Record Retrieval:** Retrieve medical charts from electronic medical record (EMR) systems, compile, and send records to designated parties for coding and billing purposes.
- **Record Requests:** Proactively contact provider groups to request medical records and ensure timely collection of necessary documentation.
- **Supplemental Records Management:** Complete and track supplemental medical record requests using Excel to ensure all required records are accurately documented.
- **Vendor Coordination:** Assist with providing updated member and provider information to external vendors for accurate processing of claims and member services.
- **Medical Record Direction:** Direct medical record requests to the appropriate party to ensure prompt and correct handling.
- **Issue Resolution:** Work to resolve outstanding vendor issues (pends) in a timely manner by updating member and provider demographics and addressing chart load discrepancies.
- **Follow-Up:** Ensure timely follow-up on member appointments, medical record retrieval tasks, and other duties as designated by the team.
- **Ad Hoc Support:** Assist with various ad hoc requests as needed to support the member outreach and claims reimbursement processes.
**Skills & Qualifications:**
- Strong attention to detail and ability to maintain organized records.
- Excellent communication skills, both verbal and written.
- Ability to handle multiple tasks and prioritize effectively in a fast-paced environment.
- Basic proficiency with Microsoft Excel.
- Customer-service-oriented with a positive attitude and willingness to learn.
- Familiarity with medical terminology and healthcare processes a plus.
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 231117 when responding to this ad.
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