Peak Vista Community Health Centers is a non-profit healthcare organization whose mission is to provide exceptional healthcare to people facing access barriers.  We provide primary care services (medical, dental and behavioral healthcare) through 28 outpatient health centers in El Paso, Teller, Lincoln, Adams, Arapahoe, Elbert, and Kit Carson counties.  We deliver care with our strong “Hospitality” culture.  Our organization has over 850 employees and serves 92,000 patients in the Pikes Peak & East Central Plains region.  Peak Vista is accredited by the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC).

Job Summary (Essential Functions)
Summary: Quality Assurance staff will complete eligibility applications with patients, and guide patients through the insurance exchange process. Quality Assurance staff will work with patients to understand how their benefits will be used at Peak Vista, to include out of pocket expectations and patient responsibility. Quality Assurance staff will educate patients on the benefits of secondary coverage. Quality Assurance staff will be responsible for many aspects of patient needs and customer service. Employees provide exceptional care, to internal and external customers, at every interaction. Quality Assurance staff will support Reception functions, across all clinics.
 
Essential Duties and Responsibilities include the following.

• Determining eligibility for CICP applications, verifying private insurance, CHP+ and Medicaid on Webportal.
• Registering patients who currently have private insurance, Medicaid, and/or CHP+ and ensure all paperwork/eligibility is reviewed with each patient.
• Data Entry into practice management systems.
• Reception duties, as assigned.
• Answering calls regarding patient coverage status, payer contract and billing questions, transferring calls to appropriate departments and other patient service duties.
• Makes appointments for enrollment and clinics.
• Supports many internal departments by providing quality customer service.
• Contributes to a culture of kindness. Adheres to assigned schedules.
• Displays a willingness to learn.
• Effectively adapts to departmental and organizational changes.
• The Quality Assurance Specialist position and job functions are a value-added service requiring commitment to Peak Vista's Core Values.
• Must also display strong detailed oriented skills with the proven ability to multitask.
• Auditing and reporting, to include all type of applications and processes, and all reception functions.
• Analysis of data sets to identify training needs.
• Performs other duties as assigned

Employee demonstrates knowledge of and adherence to the Compliance Plan and conflict of interest requirements. The employee enhances the effectiveness, efficiency and productivity of the department by contributing to, and participating in, departmental performance improvement goals.



Qualifications

Education/Experience:
Education:  High School Diploma or equivalent.
 
Work Experience:  Customer Service experience preferred.
 
Language Ability:
Verbal communication, Bi-lingual preferred
 
Math Ability:
Basic math
 
Reasoning Ability:
 
Computer Skills:
Basic computer knowledge

Physical Demands

The employee must occasionally lift and/or move up to 50 pounds. While performing the duties of this job, the employee is frequently required to stand; walk and sit. Hearing within normal range for telephone use. Looking at computer screen continuously for long periods of time


*Successful candidates will complete pre-employment screening; which includes, but is not limited to a Criminal Background check. Peak Vista Community Health Centers is a drug and alcohol free workplace an an Equal Opportunity Employer.