Overview: The EHR Provider Specialist is responsible for data and information integrity as well as providing follow–up on the status of medical record requests with personnel of provider sites. The incumbent will communicate any changes, updates or issues to Lead Review Specialist, Senior Lead Review Specialist or Operations Manager.
Duties and Responsibilities:
- Process, track and monitor client requests across all aspects of Employer’s offered services for a) EHR credentialing reviews (if applicable), b) corrective action solutions, c) HEDIS chart abstractions, d) Medicare risk adjustment reviews and e) custom chart abstractions;
- Work with team to assist and respond to Q & As for the new EHR tasks and implementations;
- Provide support in accordance with the team’s high-quality standards via telephone and other tools
- Participate and assist in the workflow and process creation;
- Schedule EHR reviews for the Electronic Review Specialist in an organized and efficient manner following Inovalon’s documented procedure for scheduling, documenting the contact and sending the required documentation to the scheduled facility;
- Responsible for Electronic Health Record recruitment and converting leads into support of closed deals;
- Provide administrative support and reports as required to management including, but not limited to, scheduling and staffing meetings, organizing and producing documents, maintaining filing systems, mailings and other daily tasks incidental to operations;
- Process and scan digital copies of received medical documents into appropriate method in a timely manner;
- Maintain liaison with Lead Review Specialist and or Operations Managers and other staff of Inovalon’s to support resolving problems concerning EHR;
- Maintain compliance with Inovalon’s policies, procedures and mission statement;
- Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon’s Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position;
- Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the Company;
- Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function; and
- We reserve the right to change this job description from time to time as business needs dictate and will provide notice of such.
Job Requirements:
- Minimum 6 -12 months industry experience and customer service;
- Adapt to changing situations while learning quickly;
- Effective written and strong verbal communication;
- Ability to relay information to ensure they understand the answer so with a clear understanding;
- Ability to work well within a fast pace team environment;
- Strong call center and sales skills;
- Ability to coordinate reviewer schedules, processes, and quality;
- Strong negotiation skills; and
- Time management and multi-tasking capabilities.
Physical Demands and Work Environment:
- Sedentary work (i.e. sitting for long periods of time);
- Exerting up to 10 pounds of force occasionally and/or negligible amount of force;
- Frequently or constantly to lift, carry push, pull or otherwise move objects and repetitive motions;
- Subject to inside environmental conditions; and
- Travel for this position will include less than 5% locally usually for training purposes.
The actual base pay offered may vary depending on multiple factors including, but not limited to, job-related knowledge/skills, experience, business needs, geographical location, and internal equity. At Inovalon, it is not typical for an individual to be hired at or near the top end of the range for their role, and compensation decisions are dependent upon the facts and circumstances of each position and candidate.
Studies have shown that women and people of color are less likely to apply for jobs unless they believe they meet every one of the qualifications listed in a job description. If you don’t meet every qualification listed but are excited about our mission and the work described, we encourage you to apply regardless. ComplexCare Solutions is most interested in finding the best candidate for the job and you may be just the right person for this or other roles.
By embracing diversity, equity and inclusion we enhance our work environment and drive business success. ComplexCare Solutions strives to reflect the diversity of the communities where we operate and of our clients and everyone whom we serve. We endeavor to create a culture of inclusion in which our associates feel empowered to bring their full, authentic selves to work and pursue their professional goals in an equitable setting. We understand that by fostering this type of culture, and welcoming different perspectives, we generate innovation and growth.
ComplexCare Solutions is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirement.
The Company maintains a drug free work environment for all of its associates, which includes employees, contractors and vendors. It is unlawful for associates to manufacture, sell, distribute, dispense, possess or use any controlled substance or marijuana in the workplace and doing so will result in disciplinary action, up to and including termination of employment or the contracted relationship.
