OF JOB DUTIES:

The person handling this position is responsible for communicating open gaps in Quality Measures to providers and staff in assigned clinic. They will be responsible for ensuring all patients scheduled for an appointment undergo an extensive chart review for any Quality measures that have been completed but not billed to insurance. This person is also responsible for making sure completed Quality Measures are billed to the appropriate insurance plan.

ESSENTIAL JOB FUNCTIONS:

• Make sure all pertinent open Quality Measures are communicated with provider and staff
• Responsible for pulling open gap reports to identify open Quality Measures
• Make sure all appropriate CPT II and ICD-10 codes go out on claims
• Perform in-house testing such as Hemoglobin A1c, urinalysis and DM Retinopathy Screenings
• Reach out to patients with open Quality Measures
• Communicate with facilities for Quality Measure results

MINIMUM REQUIREMENTS:

• Minimum of 2 years' experience in a healthcare setting as Medical Assistant (primary care experience is preferred)
• High School Diploma or equivalent is required
• Associate degree or equivalent from two-year college or technical school in medical billing, medical records or related field is preferred
• Experience in primary care office, billing/coding, front and back office preferred
• Athena EHR experience preferred

KNOWLEDGE/SKILLS/ABILITIES:

• Ability to handle multi-functions/multi-tasks
• Ability to solve problems and adapt to a fast-paced work environment
• Pay attention to detail, function autonomously
• Understanding of community-based organizations
• Ability to effectively communicate with the medical staff and Practice Administrators
• Basic knowledge of Medical Insurance and CPT coding knowledge/experience preferred
• General knowledge of primary care practice, medical clinics, and medical terminology
• Excellent verbal and written communication skills
• Strong computer skills with knowledge of Microsoft Office applications
• Able to effectively utilize an electronic health record
• Interpersonal skills
• Ability to build relationships, listen effectively, and understand the needs of the healthcare providers is vital

WORKING ENVIRONMENT

This position is an in-office position (not eligible for remote). The position requires climbing, stooping, kneeling, crouching, reaching, standing, lifting, grasping, feeling, talking, hearing, repetitive motions, and finger use. Pushing and pulling are occasionally required. Use of a computer, keyboard, and telephone along with various office machines is an essential part of the job.

DISCLAIMER

The above statements are intended to describe the general nature and level of work being performed by the Quality Specialist. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. The Quality Specialist may be required to perform duties outside of their normal responsibilities from time to time as needed or as directed by supervision.