Pay for Performance Specialist

Philadelphia, PA | Full-time | Mon-Fri

About Us

For over 55 years, Delaware Valley Community Health has been driven by our mission to serve the underserved population of Greater Philadelphia. We support each other in a friendly, dynamic, and diverse environment and treat each other like family. The work is often challenging but it’s always rewarding. We are committed to giving our people every opportunity to succeed by providing quality benefits and continuous learning opportunities to enhance the professional and personal lives of our team members.

Responsibilities

• Assist the Director of Pay for Performance Program in organizing and monitoring the Pay for Performance Program offered through a variety of medical insurance carriers.
• Review patient's electronic health record and abstract statistical and clinical data from the patient's visit.
• Support the Director of Pay for Performance Program with the organization and management of a tracking system for all expected Pay for Performance (PFP) and incentive programs to ensure efficient daily operation.
• Assist with assessing patient data to identify strategies or sources of revenue.
• Work collaboratively with DVCH staff to resolve incompleteness of Pay for Performance forms or other revenue enhancement issues identified.
• Identify and assist with scheduling appointments for patients identified with Care Gaps from member panels that have not been seen in the current year.
• Manage reports sent in by insurance carriers for "Transition of Care" purposes and communicate with health center managers to ensure appointments are made for follow-up provider visits.
• Ensure tracking of all Pay for Performance forms sent to providers and various other locations.
• Assist with the preparation of monthly/quarterly reports that track the revenue generated from Pay for Performance and incentive programs.
• Participate in webinars/meetings with insurance carriers as requested to remain current on changing issues impacting the Pay for Performance and incentive programs.
• Communicate pertinent information to the Director of Pay for Performance Program.
• Answer telephone calls, relay messages, and respond to inquiries when possible.
• Maintain filing system and file all correspondence and Pay for Performance paperwork.
• Perform general duties such as making copies, faxing, handling mail, and sending correspondence as assigned.

Requirements

• A high school diploma or equivalent is required; Associates degree preferred.
• Training as a medical assistant with a minimum of 2 years clinical experience preferred.
• Knowledge of medical insurance and billing is preferred.
• Proficient with Excel and Word applications required.
• Knowledge of medical terminology is highly preferred.
• Must possess good analytical skills and the ability to maintain an effective and organized tracking system.
• An understanding of electronic health records is preferred.

Benefits

• Medical, Vision, & Dental Insurance with HSA & FSA options
• 401k with Match and other contributions
• Employer-paid Life Insurance, Short-Term and Long-Term Disability Insurances
• Tuition Reimbursement
• Generous Paid Time Off
• Room for growth and development