Conduct comprehensive assessments Manage members through an acute medical situation or an exacerbation of a chronic condition, including testing, diagnostics, interventions Manage members during a short term sub acute rehabilitation episode Ensure accurate and complete documentation, including ICD 10 conditions Communicate and collaborate with the interdisciplinary care t

Monitor and Use Key Performance Indicators (KPIs) Gathers data for KPIs, supporting dashboards and reports Monitors operational KPIs to identify revenue cycle opportunities and address leading or lagging metrics Partners with customers to research root cause and under the guidance of senior revenue cycle business partner (RCBP) team members, identify appropriate next step

Greets patients as they arrive and manage appropriate standard wait times Complete check in and check out tasks to include patient demographic verification, insurance verification, complete pre authorizations and/or precertification of procedures, and copy required documents Collects co payments, co insurance, and deductibles and issues receipts Manages cashier box and da

Greets patients and visitors in a prompt, courteous and helpful manner Verifies insurance information, address and phone number of the patient, registers new patients Arrives patients on the computer for scheduled appointment Collects and posts co pays; Batches out at the end of the work day Schedules patients for future appointments Assists therapists with paperwork need

Manage the evaluation of payer proposals related to Fee For Service (FFS), capitation arrangements and value based contracts Partner with the payer contracting team to manage the modeling and negotiation process, evaluate proposals, and provide guidance to senior leadership on the financial impact and viability of the contract Work closely with the Finance and Actuarial t

People Actively participate in team huddles and meetings by way of sharing knowledge, requesting information, and recommending process improvements Service Work closely by way of problem solving with peers and leaders to address cash reconciliation issues or changes that directly impact the accounts receivable Process all incoming correspondence for the department Accurat

Assist patients as needed with walking, transfer, specimen collection, exam preparation, etc. Complete patient referrals and patient callbacks daily Maintain clinical supplies and equipment and ensure proper storage of biohazards Clean exam/procedure rooms, instruments, and equipment between patient visits to maintain infection control You'll be rewarded and recognized fo

Accuracy of cost of goods in internal systems and ensuring all product purchases are executed under the preferred contract and price Collaborate with contract sources including GPOs (Group Purchasing Organization), manufacturers and wholesalers to establish standard cadences and formats for catalog and price updates Manage day to day relationships with GPO partners includ

Demonstrates clinical competence in the direct care of patients in established area(s) of practice, and assisting MDs with procedures Performs clinical duties within scope of practice complying with the accepted CareMount Medical and/or individual department standards, policies, and protocols Demonstrates a proactive approach to patient care, focusing on addressing each p

Monitor day to day operations of the SPARCS Intake System including incident reports, defect tracking and resolution, extract generation, and maintenance and release activities Serve as a key resource on complex and/or critical issues Solves complex problems and develops innovative solutions Perform complex data analysis primarily in SQL to support operations Collaborate

Provides exceptional customer service to all consumers and members of the clinic staff Fills prescription orders and makes them available for verification under direct supervision of the registered pharmacist Orders, receives and stores incoming pharmacy supplies Receives and processes wholesaler medication orders Verifies medication stock and enters data in computer to m

Communicates directly with patients and / or families either in person or on the phone to complete the registration process by collecting patient demographics, health information, and verifying insurance eligibility / benefits Utilizes computer systems to enter access or verify patient data in real time ensuring accuracy and completeness of information Gathers necessary c

Assists in documenting standard operating procedures and business rules for the department Communicates with superiors, peers, employees, internal and external customers, and others, as appropriate, on a regular basis, assuring proper flow of information Assists in resolving problems relating to all areas of Patient/Third Party billings and missing information Responds to

Assisting in the review of medical records to highlight Star / HEDIS opportunities for the medical staff. Review medical records for data collection, data entry, and quality monitoring including health plan / WellMed form submission and chart collection activities that close gaps in care. Partner with the leadership team, the practice administrative or clinical staff to i

Performs all duties within the scope of a Medical Assistant's practice. Operates diagnostic equipment (cannot interpret tests), remove staples from superficial wounds, changes wound dressing and obtains cultures, administers non intravenous medication, performs simple specimen collection via noninvasive techniques and collects blood specimens via venipuncture or via capil