Transition Assistant

Shift: Day
Schedule: Full - Time Regular
Essential Functions:
  • Audit clinical records for gaps in quality care metrics and create corrective plan with CPC+ practice to facilitate collections and reporting of required quality metrics.

  • Train, educate and update CPC Plus physicians and staff on payer program metrics.

  • Assist in workflow design that promotes compliance to CPC Plus standards and clinical quality metrics.

  • Provide monthly reports to practice to assist with quality metric performance that will maximize shared savings opportunities.

  • Work with providers, care coordinators and office staff to ensure safe patient transitions.

  • Accountable for preventative care metric documentation

  • Contacts CPC Plus patients to make appointments for outstanding provider follow ups, labs and diagnostics as directed by CPC Plus providers.

  • Performs both internal and external audits for Medicare, Aetna, Horizon, Qualcare payers.  Communicates gaps in quality metrics to providers and CPC Plus management on a monthly basis.

  • Assist practice in scheduling appointments and referrals which improves accessibility of office services and patient satisfaction



Minimum Education

  • Associate’s degree or relevant years in healthcare, medical insurance billing, auditing or related field preferred

Minimum Work Experience

  • 1 – 3 years’ experience in a hospital or physician practice setting

Required Licenses/Certifications

 

  • N/A

Required Skills, Knowledge, and Abilities

  • Registry skills
  • Experience with auditing commercial medical insurance payers
  • Bilingual preferred.
  • Experience in a variety of patient settings.
  • Excellent analytical skills.
  • Good reasoning and problem solving ability.
  • Highly developed interpersonal skills.
  • Proficient at multi-tasking and prioritization.
  • Ability to work independently as well as in a team environment.
  • Highly organized.
  • Good presentation skills.
  • Demonstrated proficiency with PC and Microsoft office skills. Ability to learn and become proficient in CPC+ electronic medical records and CPC+ software applications.