Appeal Resolution Specialist jobs in Baltimore, MD

JOB DESCRIPTION :

Delivers remote patient monitoring and tele-health solutions for healthcare providers throughout the US. Our patient engagement software and services enable physicians to monitor and manage their patients' chronic conditions between office visits without investing in additional staff or money.

By combining state of the art technology with a long history of expertise in the healthcare industry, HCRS & MagnatelMD are transforming medical practices.

You will be assisting patients in self-managing their chronic conditions through a collaborative process involving the provider, our team and using a special device.

The device provided transmits their medical data remotely. As the Patient Care Assistant, you contact the patient regularly to review their medical data received.

JOB SKILLS :

• Remain up-to date of CMS regulations.
• Educate and encourage patient on program.
• Provide onsite or scheduled group, and / or individual training sessions for potential patients.
• Document patient conversation and instructions, orders, or recommendations clearly and concisely in the EMR.
• Enroll patients into the Remote Patient Monitoring Program that have been referred to by provider or generated from the EMR.
• Review patient data regularly and call patients on from the Monitoring platform; priority is given to red flag symptoms and non- compliant patients.

Escalating trends of concern.

• Educate patients on self-management skills and goal setting. These are patients with chronic conditions such as : Diabetes, CHF, COPD / Asthma, Hypertension, CAD,
• Establish and maintain positive relationships with all internal and external customers.
• Acts as a liaison for assigned patients with physicians' office.
• Utilize Motivational Interviewing or other behavior change techniques to coach and assist the patient with self-management.
• Engage patients to collaborate on optimal management of their chronic conditions.
• Communicates with providers and staff regarding patient needs and follows up as appropriate.
• Maintains compliance with standards, competencies, policies and procedures, proper documentation in the electronic medical record.
• Provide inventory management to all medical equipment.
• Provide weekly reports of patient and platform results.
• Possible travel between provider's offices to provide support to teammates.
• Performs other duties as required.
• Stay in compliance with program by utilizing reimbursable activities with the patients which include patient's use of their device daily and time spent interacting with the patient in person or via telephone.

Additional ways to communicate to patient are available as well.

MINIMUM QUALIFICATIONS :

• A Certified Medical Assistant
• At minimum of two (2) years of experience in a clinical setting
• Experience with Microsoft 365, Teams, and electronic medical records systems such as : E-clinical, Athena or NextGen
• Ability to work independently with minimal direction.
• Exceptional critical thinking skills
• Extraordinary attention to detail
• Must act with honesty and integrity.
• Great time management
• Great public speaking skills a plus

Last updated : 2024-03-02