DEPARTMENT: Geisinger Health Plan Medical Management
WORK SCHEDULE: Days/Evenings
WORK TYPE: Full Time (1.0 FTE)
Works under the direct supervision of the Medical Management (MM) Nurse Manager, Quality Improvement (QI) Nurse Manager, Senior Accreditation Coordinator, Care Coordination (CC) Senior Data Coordinator or Care Coordination Manager or Appeals Manager. Supports the Medical Management Department (MM, CC, QI, Appeals) by providing clerical support such as computer data entry, data checking, maintaining data bases, documentation and letter generation processes, provider appeals processing, record keeping, completing audits, filing, faxing, and MM Call Center coverage, managing nurse appointment schedules and recruiting Health Plan members for disease and case management programs.
COMPETENCIES AND SKILLS:
Demonstrates good organizational skills and effective communication skills.
Demonstrates good reading comprehension, writing, spelling, and English grammar skills. Must be able to perform arithmetic calculations and basic summary extract reports using a SAS based Windows environment. (CC)
Demonstrates proficiency in basic computer skills, including accurate keyboard entry of data into relevant computer based databases and spreadsheets, Neat, readable handwriting, attention to detail, and ability to be flexible in performing a variety of tasks.
Demonstrates ability to complete projects within designated timelines and the ability to prioritize duties is required.
Demonstrates proficiency with Microsoft Word and Windows & Excel, and the ability to learn GHP system software.
Demonstrates ability to use basic office equipment, computer, fax machine, copier, calculator, etc.
EDUCATION AND/OR EXPERIENCE:
High school diploma or equivalent required.
The successful candidate will possess no less than 2 years experience working in a fast paced office environment, including responsibility for accurate data entry, efficient management of high volume phone inquiries, and independent problem solving using pre-established guidelines.
Previous experience and familiarity with medical terminology and managed care principles preferred.
WORKING CONDITIONS/PHYSICAL DEMANDS:
Work is typically performed in an office environment.
The specific statements shown in each section of this description are not intended to be all-inclusive. They represent typical elements considered necessary to successfully perform the job.
OUR PURPOSE & VALUES: Everything we do is about caring for our patients, our members, our students, our Geisinger family and our communities. KINDNESS: We strive to treat everyone as we would hope to be treated ourselves. EXCELLENCE: We treasure colleagues who humbly strive for excellence. LEARNING: We share our knowledge with the best and brightest to better prepare the caregivers for tomorrow. INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and the nation.
ABOUT GEISINGER: Geisinger is a physician-led health system comprised of approximately 30,000 employees, including nearly 1,600 employed physicians, 13 hospital campuses, two research centers, and a 583,000-member health plan Geisinger is nationally recognized for innovative practices and quality care. Geisinger serves more than 3 million people in central, south-central and northeast Pennsylvania and also in southern New Jersey with the addition of National Malcolm Baldridge Award recipient AtlantiCare, A member of Geisinger. In 2017, the Geisinger Commonwealth School of Medicine became the newest member of the Geisinger Family.
We offer healthcare benefits for full time and part time positions from day one, including vision, dental and domestic partners.* Perhaps just as important, from senior management on down, we encourage an atmosphere of collaboration, cooperation and collegiality. For more information, visit www.geisinger.org, or connect with us on Facebook, Instagram, LinkedIn and Twitter.
** Does not qualify for J-1 waiver. We are an Affirmative Action, Equal Opportunity Employer Women and Minorities are Encouraged to Apply. All qualified applicants will receive consideration for employment and will not be discriminated against on the basis of disability or their protected veteran status.
*Domestic partner benefits not applicable at Geisinger Holy Spirit.
At Geisinger, our innovative ideas are inspired by the communities we serve – like our Fresh Food
Farmacy, a program that delivers life-saving healthy alternatives to patients with diabetes. With additional tools like our MyCode Community Health Initiative, one of the first health system genome sequencing
programs, and our new asthma app suite that we developed in partnership with AstraZeneca, it’s no wonder we’re ranked one of the Top 5 Most Innovative Healthcare Systems by Becker's Hospital Review. We continually work towards continuous improvement in a culture where everyone has a voice and firmly believe that better begins with all of us.
Founded more than 100 years ago, Geisinger serves more than three million residents throughout central, south-central and northeastern Pennsylvania and southern New Jersey. Our physician-led system is comprised of 30,000 employees, including 1,600 employed physicians, and consists of 13 hospital campuses, the Geisinger Health Plan, Geisinger Commonwealth School of Medicine and two research centers.
What you do at Geisinger shapes the future of health and improves lives – for our patients, communities, and you.