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Form of workKDS
Job ID 2325128
Koniag Data Solutions, a Koniag Government Services company, is hiring Medical Coordinators to support our customer in Bethesda, MD, providing excellence service to patients needing to connect with physicians for medical care.
We offer competitive compensation and an extraordinary benefits package including health, dental and vision insurance, 401K with company matching, flexible spending accounts, paid holidays, three weeks paid time off, and more.
Essential Functions, Responsibilities & Duties may include, but are not limited to:
- Recommend new ways to improve the Appointing and Referral Management Care Coordinator process. Implement approved methods.
- Monitor all of the patient call center systems (IVR, ACD, Genesis, Microsoft office suite, and all automated systems).
- Review all details of appointing rules for 600+ clinic and review referrals for suitability, administrative and clinical completeness. Coordinate the completion/booking for those pre-requisites prior to the patient’s first appointment by contacting patient, RM/ROFR Health Coordinator, Product Line nurse, clinics, or providers as needed.
- Verify patients are registered in Genesis, and DEERS information and update demographic information as needed.
- Coordinate the implementation process for reviewing and processing all patient referral requests from Humana. Provide recommendations and monitor process to ensure staff adheres to the defined timelines for response (2 days response for routine/ 90 minute for urgent).
- Coordinate process for research and communicate with requesting providers, Humana and others as needed to ensure complete medical information is available in order to make informed decisions about a Referral matter.
- Enter or copy referrals in Genesis according to MHS/IRMAC standard operating procedures.
- Provide recommendations to assist other ROFR staff when advising all categories of patients regarding their referrals and access to care options as related to their eligibility and beneficiary status.
- Coordinate process for appointing and tracking referral in Genesis and/or CHCS. Search all MTFs for availability, based on clinic guidance and available appointments within the Genesis.
- Ensure equitable distribution of call center workload between MTFs and among the NCA appointing staff as required.
- Ensure that Call Center phone system applications are running on their computers immediately upon logging in for work.
- Schedule patients in Genesis for appointments at any MTF in the National Capital Region eMSM based upon Appointing Business Rules and protocols.
- Verify patients are registered in Genesis; if not appointing staff will register patient in Genesis based on DEERS (Defense Enrollment Eligibility Reporting System) information; update patient demographics information as needed.
- Assist with other duties within the Appointing or Referral Management Office related to appointing or the processing of referrals to Direct Care MTFs and Civilian Care per IRMAC responsibilities.
- Review and prepare monthly Appointing reports through the Call Management System (CMS), Desktop Process and Analytics (DPA) system and the AVAYA Contact Recorder (ACR).
- Maintain effective communication with appropriate staff and work closely with technical staff to ensure efficient operation.
- Perform miscellaneous administrative duties as assigned.
- Ensure equitable distribution of appointing workload between teams and among the NCA appointing staff as required.
- Assist with training and orientation of new Medical Appointing Coordinators as needed. Ensure that the appointing staff is trained and demonstrate understanding of the appointing process as required.
- Maintain effective communication with appropriate staff and work closely with technical staff to ensure efficient operation.
- Monitor and report time and attendance
- Travel as requested.
Work Experience, Knowledge, Skills & Abilities:
- Minimum of three-year experience working in a medical environment, customer service Call Center, preferably with emphasis on appointment scheduling and/or referral management.
- Must have US Citizen Status to work
- Shall be able to read, write, speak and understand at English.
- Thorough knowledge of the Military Health Care System, TRICARE, medical terminology, release of medical information, and medical and legal ethics.
- Good customer service skills in dealing with patients and all staff
- Demonstrated knowledge of basic Medical Terminology: a Basic Medical Terminology Couse is preferred, but not required.
- Accurate data entry and attention to detail.
- Standard office administrative practices and procedures, including the use of standard office equipment to accomplish clerical, statistical and data entry tasks in support of the administrative work of the office.
- Expert understanding of Genesis, and Appointment Call center Software, IVR, ACD, and AVAYA systems.
- Superior customer service and organizational skills.
- Strong verbal and written communication skills and sound judgment.
- Ability to provide technical expertise, medical management guidance, and appointing and referral management strategies to improve the efficiency of the operations.
- Proficiency in the Microsoft Suite of Products, including, Word, Excel, PowerPoint and Access preferred.
Working Environment & Conditions
This position is primarily indoors, consistent with a standard office position and has a noise level of mostly low to moderate. The incumbent is required to stand; walk; sit; use hands to finger, handle, or feel objects, or controls; reach with hands and arms; talk and hear. The work load may require the incumbent to stand for extended periods of time. The incumbent must occasionally lift and/or move up to 25 lbs. Specific vision abilities required by the job include close vision, distance vision, color vision, depth perception, and the ability to adjust focus.
Our Equal Employment Opportunity Policy
The company is an equal opportunity employer. The company shall not discriminate against any employee or applicant because of race, color, religion, creed, sex, sexual orientation, gender or gender identity (except where gender is a bona fide occupational qualification), national origin, age, disability, military/veteran status, marital status, genetic information or any other factor protected by law. We are committed to equal employment opportunity in all decisions related to employment, promotion, wages, benefits and all other privileges, terms and conditions of employment.
The company is dedicated to seeking all qualified applicants. If you require an accommodation to navigate or to apply to a position on our website, please contact Heaven Wood via e-mail at accommodations@koniag-gs.com or by calling 703-488-9377 to request accommodations. This contact information is used for accommodation requests only and cannot be used to inquire on a status of your application.
About our Company
Koniag Data Solutions (KDS) is a newly established Alaskan Native-owned, small disadvantaged business that is part of the Koniag Government Services group. KDS supports Federal civilian and defense agencies and State governments across multiple business functions including: Finance, Health, Defense, Social Services, Consumer Protection and Insurance.
EOE Minorities/Female/Protected Veterans/Disabled. Shareholder Preference in accordance with Public Law 88-352
