Transition Assistant Job at Hackensack Meridian Pascack Valley Medical Center

Hackensack Meridian Pascack Valley Medical Center Westwood, NJ 07675

Overview:
Why Pascack Valley?
Our People. Our people truly are our greatest strength. They make a massive difference in the amazing care we provide every day. We work closely together to create a positive experience for our patients and each other.

Our Purpose.
In a joint venture partnership with Hackensack Meridian Health, New Jersey’s largest and most comprehensive and integrated health network, Ardent operates Hackensack Meridian Mountainside Medical Center, located in Montclair and Hackensack Meridian Pascack Valley, located in Westwood. We will build on your experience and provide meaningful and purposeful career growth for your future. You will have the opportunity every day to make a difference in someone’s life and change the course of healthcare.
Responsibilities:
What You'll Do
The CPC Plus Transition Assistant works closely with the Care Coordinator, Physicians and staff in coordinating and communicating gaps in quality care metrics for all CPC Plus patients. They assist with low risk patient navigation and preventative screening compliance. The Transition Assistant works independently to audit clinical data and assist in educating CPC Plus providers and staff. This promotes workflows that support quality patient care and compliance with documentation and clinical outcome metrics. The Transition Assistant will communicate with the healthcare team to assist patients in transitions of care across the healthcare continuum. Finally the Transition Assistant is accountable along with the care coordinator for training and continually updating CPC Plus practice staff to meet clinical quality guidelines and facilitate high quality safe patient care.
The successful candidate will be able to:
  • Audit clinical records for gaps in quality care metrics and create corrective plan with CPC+ practice to facilitate collections and reporting of required quality metrics.
  • Train, educate and update CPC Plus physicians and staff on payer program metrics.
  • Assist in workflow design that promotes compliance to CPC Plus standards and clinical quality metrics.
  • Provide monthly reports to practice to assist with quality metric performance that will maximize shared savings opportunities.
  • Work with providers, care coordinators and office staff to ensure safe patient transitions.
  • Accountable for preventative care metric documentation
  • Contacts CPC Plus patients to make appointments for outstanding provider follow ups, labs and diagnostics as directed by CPC Plus providers.
  • Performs both internal and external audits for Medicare, Aetna, Horizon, Qualcare payers. Communicates gaps in quality metrics to providers and CPC Plus management on a monthly basis.
  • Assist practice in scheduling appointments and referrals which improves accessibility of office services and patient satisfaction.
  • Travel to assigned CPC Plus offices to ensure compliance with CPC Plus policies and procedures as directed by CPC Plus management.
  • Work with management and care coordinators to utilize CPC Plus software to create and report on CPC Plus outcome measures such as ER, inpatient and sub-acute usage.
  • Audit medical records to ensure documentation conforms to CMS standards for inclusion and exclusionary clinical guidelines.
Qualifications:
What You'll Bring
  • Associate’s degree or relevant years in healthcare, medical insurance billing, auditing or
    related field preferred
  • 1 – 3 years’experience in a hospital or physician practice setting
  • Registry skills
  • Experience with auditing commercial medical insurance payers
  • Bilingual preferred.
  • Experience in a variety of patient settings.
  • Excellent analytical skills.
  • Good reasoning and problem solving ability.
  • Highly developed interpersonal skills.
  • Proficient at multi-tasking and prioritization.
  • Ability to work independently as well as in a team environment.
  • Highly organized.
  • Good presentation skills.
  • Demonstrated proficiency with PC and Microsoft office skills. Ability to learn and become proficient in CPC+ electronic medical records and CPC+ software applications
What We Offer
  • Competitive pay
  • Medical, dental, and vision insurance
  • 401k with Company match
  • Company paid basic life insurance and long term disability coverage
  • Generous paid time off, including an additional extended illness bank
  • 6 Paid Holidays
  • Tuition Reimbursement
  • Advancement and career development opportunities
Hackensack Meridian Health Mountainside Medical Center is an Equal Opportunity Employer and applicants will receive consideration for employment regardless of race, color, age, national origin, religion, sexual orientation, gender identity, status as a veteran, and basis of disability or any other federal, state or local protected class.



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