AmeriHealth Caritas Jobs

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AmeriHealth Caritas Coordinator MCR Data Integrity in Philadelphia, Pennsylvania

Coordinator MCR Data Integrity

Location: Philadelphia, PA

Primary Job Function: Medicare

ID**: 21316

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com .

Responsbilities:

The Medicare Data Integrity Coordinator is responsible for ensuring and improving the performance, of data integrity through the provision of effective methods and strategies. Under the supervision of the Manager, Medicare Data and Revenue Integrity, the Medicare Data Integrity Coordinator is responsible to provide support for the enforcement of data integrity, compliance and quality assurance standards.

  • Responsible for helping to ensure the quality, compliance and accuracy of information entered into electronic systems and produced reporting.

  • Perform data integrity validation reviews on records in various data formats and systems including auditing data input.

  • Follow established workflows

  • Document and report service quality levels

  • Communicate with other team members to solve problems

  • Follow up with the appropriate channels when mistakes are found

  • Help ensure operations are in compliance with an organization’s standards, as well as any applicable state and federal regulations.

  • Help to ensure goals are met for productivity, quality of service and overall effectiveness.

  • Maintains a current knowledge of CMS and DHHS requirements and updating job knowledge by engaging in educational opportunities and regular training.

  • Adheres to AmeriHealth Caritas policies and procedures.

  • Creates and supports an environment which fosters teamwork, cooperation, respect and diversity.

  • Instills work culture of continuous process improvement, innovation and quality.

  • Demonstrates and supports commitment to corporate goals and objectives.

  • Performs other related duties and projects as assigned.

Education/ Experience:

  • Associate’s Degree preferred.

  • 1 to 3 years experience.

Other Skills:

  • Proficient PC skills with Microsoft Office Suite (Word, Excel, etc.).

  • Excellent technical ability.

  • Strong analytical skills.

  • Excellent problem solving and organization skills.

  • Ability to work independently or as a team.

  • Ability to navigate through multiple software systems simultaneously.

  • Strong interpersonal communication skills.

  • Ability to maintain positive relationship with both internal and external customers.

  • Process Oriented.

  • Attention to detail.

  • Effective time management.

  • Pro-active with ability to multi-task.

  • The ability to consistently identify mistakes.

  • The ability to closely follow quality standards.

  • Decision making skills.

EOE Minorities/Females/Protected Veterans/Disabled

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