Quality Specialist/Medical Assistant

Brief Description

Why MCR Health?

A career at MCR Health offers exciting opportunities with one of the largest Healthcare companies in the areas we serve. Now, more than ever, we are looking for exceptional people to support our passion to provide "Exceptional Care to Everyone, Every Time" and to support our Mission to serve everyone. Whether you are providing direct patient care or in other areas of our Company, you can find a home here. We invite you to be part of our community, where you can grow your career and serve with your heart.

In our time of Company growth, we are seeking a Quality Specialist/Medical Assistant

Work Location: Bradenton, FL

As Part Of This Role, You Will

• Has an excellent understanding of telephone usage and the operation of the telephone system
• Answers incoming telephone calls within three (3) rings and accurately directs and/or assists the caller
• Forwards calls accurately to the correct person or extension and ensures that someone is answering on the extension before passing the caller
• Demonstrates competency and proficiency with the electronic medical patient information system
• Calls patients to schedule advanced appointments and accurately enters new or follow-up information into the electronic medical patient information system
• Obtains, verifies, and/or updates demographics and insurance information in the appropriate electronic patient health information systems
• Explains services and operating hours; knowledgeable about services offered
• Informs and guides patients to appropriate resources
• Work collaboratively with the payers to obtain total Provider-Patient Panels
• Understands all Insurance Rules and Regulations regarding HEDIS Measures
• Ensure appointments are scheduled appropriately, appointments are completed, and Quality Measures are met
• Work directly with Providers to improve quality and access to care
• Work directly with Billing on Corrective Claims
• Reach out to non-compliant members to determine the reason
• Communicate with the insurance payers on discrepancies and non-compliant members
• Monitor and maintain Provider schedules
  
  

Requirements

What you need to bring to this role:

• High School Diploma /GED minimum
• Medical Assistant/nursing education preferred
• 6 months of experience in a healthcare environment required
• Knowledge of medical terminology required
• Minimum of six months of customer service experience in a high-volume impact environment, preferably in healthcare
• Billing and Coding experience is beneficial
• Proficiency in Microsoft Office Suite required
• Valid driver’s license required with the ability to move between sites as needed to oversee, observe, and monitor operations
• Bilingual (Spanish/English) a plus
  
  

Summary

The Quality Specialist is responsible for friendly, courteous, professional, and informative customer service to the company’s patients seeking to enhance member engagement, compliance, patient health, and satisfaction. Improve quality, access to comprehensive care, and schedule appointments to meet Quality Measures.

• MCR Health is a drug-free workplace. All job applicants selected for employment are required to submit to a pre-employment drug test and background check.