Coordinator - Risk Management - Full Time
Riverside Medical Clinic
Responsibilities Come and join the RMC Family! We have been in the community since 1935. Our mission is to provide comprehensive multi-specialty medical services in the greater Riverside region. Your passion, inspiration, and talents are invaluable to us and our mission to serve others. Our facility can provide a place for you to thrive and continue your professional development. Quality Healthcare is our passion, improving lives is our reward. We are working to change lives and transform the delivery of healthcare. Riverside Medical Clinic is the best place to work, practice medicine, and receive care. SUMMARY: Maintain original signed policies and procedures, and maintains Table of Contents to ensure most current, up to date P&Ps. Track progress of revised/new P&Ps through the approval process, obtain required signatures on approved P&Ps, and tracks P&Ps through the approval process. Acts as the liaison between malpractice lawsuits and providers, as well as Corporate Risk. Stays up to date on current litigations and incidents/occurrences within RMC. QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential function satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. HOURS: Monday - Friday 8:30am-5:30pm ONSITE Qualifications EDUCATION and/or EXPERIENCE: Associates Degree or higher. Computer skills required: Experience with Microsoft Office (Word, Access, Excel) Medical training background desirable Risk Management experience desirable CERTIFICATES, LICENSES, AND REGISTRATIONS: LVN preferred.
ESSENTIAL FUNCTIONS
Essential functions are those tasks, duties and responsibilities that comprise the means of accomplishing the job’s purpose and objectives. Essential functions are critical or fundamental to the performance of the job. They are the major functions for which the person in the job is held accountable. Note: (other duties may be assigned, deleted or changed at any time, at the discretion of management, formally, or informally, either verbally or in writing).- Procure charts for Medical Record Audits and prep for monthly peer review.
- Accept summons/subpoenas/letters of intent, on behalf of RMC and Physicians. Forward notice to malpractice carrier and Medical Directors. Sequester medical records upon receipt of notice and forward copies to insurance carriers. Prepare duplicate chart for circulation. Maintain original and duplicate chart to assure both are current.
- Send out meeting notifications and assists with meeting packet preparation. Procures charts for special or focused QRM studies. Return medical records to the proper chart home base, upon completion of audits. Maintain QRM correspondence and files in a secure, organized and current state.
- Mail quarterly reports to health plans in a timely manner.
- Resolve customer complaints or forward to QM Specialist for resolution. Collect and enter statistical data in established database.
- Complete data entry in an accurate and timely manner.
- Maintain the privacy of both internal and external clients. Monitors/documents HIPAA compliance/violations.
- Monitors provider open and encounters and prepares memos for fine collection.
- Any other duties requested by Manager, Quality and/or Regional Director, Quality
$18.33 - $23.06 per hour
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