Member Risk Adjustment Coordinator I

Position Purpose: Schedule appointments, gather medical histories and updated member and provider information in support of member outreach and claims reimbursement.
Responsibilities:
• Assist members with scheduling office visits with primary care provider.
• Retrieves charts from electronic medical record systems and compile medical records to send to other parties for coding.
• Requests medical records by making outbound phone calls to provider groups.
• Completes supplemental medical records requests using Excel files.
• Assist with providing updated member and provider information to vendors.
• Directs medical record requests to the responsible party.
• Resolves outstanding vendor pends within a timely manner by updating member and provider demographics and working with chart load issues.
• Ensure follow up on member appointments or other tasks designated.
• Assist with ad hoc requests.