- Compile and maintain patients’ medical records to document condition and treatment and to provide data for research or cost control and care improvement efforts.
- Plan, develop, maintain, or operate a variety of health record indexes or storage and retrieval systems to collect, classify, store, or analyze information.
- Manage the department or supervise clerical workers, directing or controlling activities of personnel in the medical records department.
- Protect the security of medical records to ensure that confidentiality is maintained.
- Assist member in providing information regarding their heath plan and educating them about community resources
- Complete daily documentation and weekly report to ensure compliance with state an organization policy is being met
- Utilize HHSC Handbooks, SOP’s and workflows to efficiently and accurately make nonclinical decisions
- Entering authorization in QNXT and notifying the provider of approved LTSS Services
- Utilize a high level of quality in client service through the execution of accuracy, responsiveness, reliability and professionalism on every interaction
- Utilizing customer service skills to communication with clients, providers ad clinical staff
- Answer inbound calls from members and providers regarding eligibility, benefits, and authorizations wile documenting the call
- Schedule appointments between potential client and sales associate.
- Arrange public appearances and event booths for clients to increase product or service awareness.
- Track the day to day outreach to potential clients through the use of Spotio, Door to Door Sales application.
- Responsible for making outbound follow up calls to members and providers
- Investigate, identify, initiate and respond to opportunities to create or participate in marketing activities that lead to membership growth
- Assist with planning, implementing and coordinating both sales and non-sales events for all assigned products
- Tracks and measures various sales event effectiveness. Assists with designing and measuring overall sales event strategy
- Provide input, support and feedback on promotional opportunities, benefits, and other issues
- Prepare preliminary budget recommendations for each approved agreement
- Ensure all agreements are properly filed with appropriate regulatory agencies
- Meet established goals and deadlines to include addressing identified gap
- Identify cases of domestic abuse or other family problems and encourage individuals
- Recruit sponsors, participants, or volunteers for fundraising events.
- Support Service Coordinators (RN’s, LVN’s and Social workers) within the health services department
- Resolve member and provider complaints by gathering information, investigation information reported and finding resolution