Job DescriptionJob DescriptionPOSITION SUMMARY:CCI Health and Wellness Services is seeking a Patient Representative to act as the point of contact by greeting patients and visitors in person and over the phone and directing them to the appropriate Health Center personnel. The PR will assure that the provision of high quality; cost efficient, culturally sensitive services comply with all Federal, State and Local agency policies and procedures.
KEY FUNCTIONS &RESPONSIBILITIES:•Answers the telephone promptly, identifies him/herself and the center, refers calls to the appropriate area, and identifies and refers urgent calls correctly. Accurately communicates phone messages as needed.•Makes and assists in scheduling return appointments, confirming the patient’s demographics and updates it in the computer system as necessary.•Registers patients. Calls patients to remind them of scheduled visits per center routine.•Checks in patients as they enter the center, identifies in the system whether they are a “Arrived”, “No-Show”, “Walk-In”, or a “Cancellation”. •Notifies appropriate personnel of patient’s arrival (per center routine) and secures patients medical record for use by Medical Assistant. •Monitors status of reception areas, updating appointment status by end of day, alerting clinical staff of unusually long patient waiting times or obtaining assistance of any unusual situations including patient conflicts.•Performs other clerical support functions; scanning, scheduling and documentation of appointments or referrals, completes medical records release forms. Prints provider schedule the day before. •Review the schedule the day before to better prepare needed registration updates to ask from the patient, such as; HIPAA, Consent to Treatment, MCHATS, ASQ, patient profiles and any other paperwork as needed. •Exhibits and promotes a standard of excellence in the performance of all duties and interactions with patients, co-workers and outside contacts. •Work with various programs such as dental, family planning, behavioral health and follow the policies and procedures, workflows and/or guidelines. •Process billing and collections.•Deliver any patient care instructions.
EDUCATION AND EXPERIENCE:•Minimum High School diploma, preferably an AA or BS degree•Must have at least one year of relevant work experience, preferably in a medical setting or an equivalent combination of training and experience in order to perform office routines and clerical support functions.•Customer service required.•Computer skills required.
OTHER SKILLS AND ABILITIES:•Preferred bilingual•Must possess excellent communication and interpersonal skills in order to greet patients and visitors in person or over the phone, and to direct them accordingly. •Ability to maintain a high standard of customer service and observance of corporation protocol in a hectic and sometimes hostile situation.•Ability to read and write in order to update patient information/forms, accurately communicate phone messages, and respond to visitors and callers as needed.
Job DescriptionJob DescriptionCCI Health Services’ mission is to deliver high quality, accessible care to our community members, leading the way to a more equitable health care system for everyone.
**This position is 100% On-call/PRN***RESPONSIBILITIES: Provides pharmacy information by answering questions and requests of health care professionals and counseling patients on drug therapies.Develops clinic staff's pharmacy knowledge by participating in clinical programs and training pharmacy staff, students, interns, residents, and health care professionals.Complies with state and federal drug laws and regulations.Maintains records for controlled substances and removes outdated and damaged drugs from the pharmacy inventory.Maintains separate 340B drug inventory as appropriate.Supervises the work results of support personnel.Maintains current registration.Protects patients and technicians by adhering to infection-control protocols.Maintains a safe and clean working environment by complying with procedures, rules, and regulations.Contributes to team effort by accomplishing related results as needed.Other duties and responsibilities as assigned and necessary to successfully oversee Pharmacy Services.REQUIRED SKILLS: Ensure safe prescribing and dispensing of medication.Knowledge of FDA, BOP, and all applicable regulationsAbility to manage processes and develop implementation strategies.Knowledge of retail pharmacy legal complianceFamiliarity with adherence packaging and home deliveryPrevious experience in a pharmacy, retail, medical, or customer service settingStrong analytical and organizational skills including the ability to analyze data to identify trends and communicate them through effective reporting methods.Strong attention to detail.Excellent oral, written, and verbal communication skills including experience presenting complex information to senior leaders.Skilled in exercising a high degree of initiative, judgment, discretion, and decision-making to achieve objectives.DESIRED OTHER SKILLS: Familiarity with 340B program.Familiarity with HRSA and Joint Commission.Familiarity with Federally Qualified Health Centers.QUALIFICATIONS: Graduate degree from an accredited pharmacy college recognized by the American Council of Pharmaceutical Education (ACPE).One (1) year related experience.Valid State of Maryland Pharmacist license.Board eligible.CPR or CPR/AED certificate.WORKING CONDITIONS: Proper and professional grooming is always expected.Prolonged periods of standing, bending or working at a desk on a computer.The ability to lift (up to 15lbs) is required. Work under stressful conditions within a controlled enclosed environment daily. The work environment involves exposure to potentially dangerous materials and situations that require extensive safety precautions and may include the use of protective equipment. ADA Category. In accordance with the American with Disabilities Act, it is possible that requirements may be modified to accommodate disabled individuals. However, no accommodation will be made which may pose serious health or safety risks to the employee or others or which impose undue hardships on the organization. OSHA Category 1. Clinical environment. Possibility of exposure to chemicals and infectious body fluids e.g., HPV, HIV, HEP C, HSV.Additional Information: Hours of Operation: Monday – Friday 8:00 – 4:30pm This position will be 100% on-site, customer facing at CCI’s Gaithersburg/Ora Glen location and other locations where pharmacy duties are assigned
Job DescriptionJob Description
CCI Health Services’ mission is to deliver high quality, accessible care to our community members, leading the way to a more equitable health care system for everyone. KEY FUNCTIONS & RESPONSIBILITIES: Essential Functions: Provide customer service to patients dropping off or picking up prescription ordersEnters and processes prescription ordered into the computer and consults with pharmacist as neededRetrieve, count, and set-up orders to support the work on the pharmacist.Creates a profile of the patient’s health and insurance information in the computer system and updates patients’ profiles as neededAnswers and effectively responds to phone callsAssist the pharmacist and other medical staff, under the supervision, in the practice of pharmacy in accordance with local, state, and federal regulations and organizational policy and protocols.Communicates with insurance carriers to obtain payment for prescriptions claims and trouble-shoots insurance coverage to ensure resolution Receives inventory, stock shelves, rotates stock, and verifies all associated documentation.Prepares pharmacy inventory, orders medications and other supplies as needed. Conducts end of the month inventory, removes and disposes of any expired stock per organizational policy/protocol/procedures.Communicates with medial staff to obtain refill authorization and refers patients for appointments, as necessary.Operates cash drawer at point of sales.Closely follows all policies and procedures pertaining to operating a 340b pharmacy.Help with record keeping requirements of the pharmacy.Communicates and works closely with the pharmacist to provide safe, efficient, and accurate care to all patients.Complies with CCI’s Policies and Procedures, Standards of Conduct, Code of Conduct and Corporate Compliance.Secondary Functions: Assist the Pharmacist in training new Pharmacy employees. Performs back-office duties such as data uploading of referral notes for patients, or patient interviews for medication reconciliation review or 340B referral compliance or auditing. Front office duties as required or assigned work pertaining to the Pharmacy operations and Pharmacy 340B program.May travel to provide coverage in other sites or to participate in training programs or continuing education. Understands role in Disaster Plan and that safety is a condition of employment.Serves on various CCI and community committees as requested/required.Maintains any necessary educational or licensure requirements. Other duties as assigned. Minimum Requirements: Pharmacy Technician certification required. Highschool diploma or equivalent required. 1-2 years of experience working in a retail pharmacy or FQHC, a plus. Understanding of the 340B discount program. Ability to work with people from different cultural, racial, and socio-economic backgrounds. Additional Information: Hours of Operation: Monday – Friday 8:00 – 4:30pm This position will be 100% on-site, customer facing at CCI’s Gaithersburg/ Ora Glen location and other locations where pharmacy duties are assignedThis position is 100% on-call/PRN** CCI Health Services is an Equal Opportunity Employer**
Job DescriptionJob DescriptionCCI Health Services’ mission is to deliver high quality, accessible care to our community members, leading the way to a more equitable health care system for everyone.
As a member of the health center’s integrated care team, the Chief Medical Officer (CMO) will fulfill the following KEY FUNCTIONS AND RESPONSIBILITIES towards the provision of patient-centered, coordinated patient care:Supervises and actively participates in the timely hiring, coordination, and onboarding of new clinicians with the appropriate Health Center Medical Director. Responsible for achieving and maintaining provider-specific staffing goals and quality metrics. Provides direct supervision to Medical Directors and serves as Acting Medical Director as needed. Ensures provider productivity targets are met and maintained.Provides oversight to ensure patient safety, quality, infection control, risk management, and patient service, especially those related to provider issues. Provide treatment to minors with or without accompanying parents.Provides consultation, development, and approval of CCI medical policies, protocols, and procedures in accordance with currently accepted professional standards governing the practice of medicine and the clinical provision of medical care, ensuring that policies conform to all applicable company, local, State and Federal policies and requirements. Ensures all clinical staff adhere to agency policies, workflows, and team-based care standards—promoting alignment with organizational processes and reinforcing that clinical practice operates within, not separate from, the broader agency structure.Oversees and guides medical decision-making related to public health measures, including but not limited to infectious disease response (e.g., mask mandates, vaccine protocols, and outbreak management), in alignment with local, state, and federal guidance.Champions innovation in clinical practice and service delivery, including the design, implementation, and evaluation of pilot initiatives to improve care effectiveness, operational efficiency, and team-based workflows.Coordinates with program directors, senior leaders, and managers to provide clinical consultations or recommendations for medical services-related programs including, but not limited to, Prenatal, Behavioral Health, Family Planning, Infectious Disease, and 340B.Contributes to clinically related portions of required reports such as UDS, Joint Commission, and organizational strategic & operational plans. Responsible for assuring a robust peer review and credentialing process, ensuring quality, safety, service, and behavioral issues on the part of the provider staff are addressed fairly and in a timely fashion.Provides oversight for the Medical, Behavioral Health, Psychiatry, Quality, Credentialing, School Based Wellness and Nursing Departments of the organization.Provides primary medical services to patients one day each week, including examination, diagnosis, treatment, education, and prevention in conformance with accepted clinical protocols & guidelines. Makes referrals for specialty consultation and/or treatment as required.Maintains a strong, visible presence through regular site visits and active engagement with clinical staff across all locations, fostering connection, trust, and alignment to build one cohesive, collaborative clinical team.Maintains accurate and timely patient medical records in accordance with CCI policies, using its Electronic Health Record. Completes in a timely fashion all referrals, forms, reports, and other records as required for quality services and program support.Plays a leadership role in understanding, communicating, achieving, and maintaining quality standards (Joint Commission, NCQA, HRSA and others) and Patient-Centered Medical Home (PCMH) principles. This includes the implementation of QI/QA operating procedures, completion of QI/QA assessments, and facilitation quality related meetings. Maintains professional competence by completing appropriate requirements of CME; maintains certifications; participates in professional development activities.Supervises the required components of Employee Health Records, including tuberculosis, Hepatitis B, and influenza prevention. Leads meetings and projects as directed by the CEO.Actively participates in the Executive Team and Senior Leadership meetings and projects.Assists the appropriate staff in the solicitation, development, management, and evaluation of any grants deemed necessary and useful to the function of CCI.Represents CCI at local, state, national, and community meetings and in clinical advisory committees as required or requested.Attend Board Meetings and/or respond to related inquiries as needed.Other duties as assigned.SUPERVISORY RESPONSIBILITIES: Provides direct supervision to Medical, Program, and Department Directors in accordance with the organizational chart. MINIMUM QUALIFICATIONS:Graduation from an accredited school of medicine and successful completion of a residency program. Additional graduate-level degree/training in business, administration, public health, and Information Technology is strongly preferred.Current licensure by the State of Maryland, unencumbered by any restrictions or limitations.Training in Family Medicine perferred.Five (5) years of experience in direct provision of primary care services, preferably in a community health center serving culturally diverse and underserved patient populations. Three (3) years of experience as a Medical Director and team supervisor is required. Chief Medical Officer experience is preferred.Understanding and appreciation of the financial aspects of a healthcare organization and the need to generate sufficient resources to support the strategic goals and mission of the organization.Experience in the development & management of quality, risk, & utilization review processes.Ability to make difficult decisions; build leaders; hold others and self-accountable.Demonstrated leadership, communication & analytic skills.Working on-site is an essential duty for the job. Bilingual/multi-lingual is highly desirable. WORKING CONDITIONS:Prolonged periods of standing, bending or working at a desk on a computer.The ability to lift (up to 15lbs) is required.
Job DescriptionJob DescriptionPosition Summary:The Procurement Manager supports CCI through the administration of procurement. This position is responsible for all facets of the coordination and management of vendor contracts and procurement and related documentation. This role provides management, administrative and operational support around agency contract and vendor engagement, monitoring, and tracking. Additionally, this position assists with all phases of procurement including but not limited to data entry, vendor follow up, RTP processing, tracking, etc. This position ensures that procurement processes are efficient, transparent, and compliant with federal and state regulations, including HRSA and Uniform Guidance requirements. The Procurement Manager provides the leadership, management, and vision necessary to ensure that senior management are advised on procurement Resources.KEY FUNCTIONS AND RESPONSIBILITIES: Researches and writes Request for Proposals (RFPs) and commodity or service contracts based upon agency requirements for submission for public bidding;Manage the end-to-end procurement process - e.g., needs assessment, RFQs/RFPs, bid evaluation, contract negotiation, and purchase order management.Maintains repository of all CCI contracts and related documents. Lead strategic sourcing initiatives to ensure cost-effective purchasing while maintaining quality and compliance.Negotiates with contractors and vendors on complex and technical services and technology required to obtain the best quality and price for the agency.Confers with internal and external requisitioning personnel to ascertain, determine, and analyze short-term and long-term services and technology requirements.Appears before the Board and other CCI leadership, as necessary, to explain contract specifications, technical, and legal requirements, costs, and problems.Interviews vendors to obtain price and product information concerning the ability of vendor to supply product or service and to meet delivery dates; makes recommendations on products, services, and technology on behalf of CCI.Investigates, analyzes, and resolves service disputes between CCI and entities and vendors.Writes, reviews, and submits correspondence to supervisors for review and comments on behalf of CCI to external entities and vendors.Maintains close liaison with other department users on commodity, technology and service needs and problems.Enter all work in CCI’s electronic procurement system.Plans, coordinates, and oversees the purchase of equipment, materials and services for CCI.Processes and coordinates requisitions with the Controller and CFO, who has final determination of the requirements to be advertised and the award to be made.Drafts purchasing descriptions, specifications, and statements of work to assist in processing purchase requisitions.Monitors the delivery of equipment and expedites the correction of purchasing orders.Analyzes and develops cost projections for materials, equipment, and contractual services; recommends and monitors expenditures.Administers procurement and service contracts; participates in vendor selection as needed; monitors contracts to ensure compliance with specifications and conditions.Analyzes CCI policy and procedures for impact on procurement and expenditures; recommends alterations to existing systems to improve accountability and cost effectiveness.Prepares and reviews technical specifications for equipment, materials, and services for submission to the CFO or Executive Team.Establishes procedures for identifying and correcting waste, fraud, and misuse of CCI resources.Studies market trends to remain abreast of changes in equipment, material, and services available; examines CCI requisitions to determine purchasing patterns and trends.Serves as agency data processing coordinator with responsibility for planning and coordinating all CCI acquisitions of computer equipment and materials; and Performs related work as required.MINIMUM QUALIFICATIONS:Bachelor's degree in Business Administration, Supply Chain Management, Public Health, or a related field.3+ years of experience in procurement or supply chain management, preferably in healthcare or nonprofit setting.Familiarity with Federal procurement standards (e.g., Uniform Guidance). Related experience in an FQHC or nonprofit, a plus.Strong negotiation, organizational, document and project management skills.Excellent written and verbal communication skillsWORKING CONDITIONS:Proper and professional grooming is always expected.Prolonged periods of standing, bending or working at a desk on a computer.The ability to lift (up to 15lbs) is required. Ability to work in a fast-paced, controlled/enclosed, and complex environment.Potential exposure to materials and situations that require extensive safety precautions and may include the use of protective equipment.
Job DescriptionJob DescriptionPOSITION SUMMARY:The Pediatrician provides direct care to CCI patients commensurate with training and experience. The care provided is appropriate for an out-patient, primary care community health center with a multicultural, multilingual patient population.As a member of the health center’s integrated care team the Physician will fulfill the following KEY FUNCTIONS AND RESPONSIBILITIES towards the provision of patient-centered, coordinated, patient care:Examine, diagnose, and treat children who have minor illnesses, injuries, infections, and acute and chronic health problems.Plans and implements medical care programs for patients, from birth through adolescence, to aid in physical and mental growth and development.Provide treatment to minors with or without accompanying parents.Determines nature and extent of disease or injury, and prescribes and administers treatment, and therapy. Medications, immunizations, and preventative health practices.Adhere to evidence-based medical guidelines and standards approved by CCI’s Board and Performance Improvement Committee.Complete electronic medical records in expected time frames; target encounters 16 to 22 per day.Participate in peer review and performance improvement activities and audits.Attend and participate in meetings and/or committees, as necessary and/or required by CCI.Participate in additional medical projects as assigned.May provide supervision for Physician Assistants and Nurse Practitioners.May provide consultation to other providers at CCI.May instruct medical students and/or residents in procedures for diagnosis and treatment of diseases and injuries.Working on-site is an essential duty for the job. Other duties or responsibilities as assigned by the Chief Medical Officer or designee.KNOWLEDGE, SKILLS, AND ABILITIES:Knowledge of the principles and practice of medicine (including preventive care and acute/chronic disease management).Practical experience with using EMRs and general office software and applications.Knowledge of the state and federal laws pertaining to medicine and to community health centers.Knowledge of the structure and function of community health centers.Skill in communicating effectively with patients and their families.Skill in establishing and maintaining effective working relationships with other employees, patients, and general public.MINIMUM QUALIFICATIONS:Must be Board certification eligible. Board-certified preferred.Active Maryland CDS license. DEA licensure.Current BLS certificationHave a thorough knowledge of the principles and practices of pediatric medicine and allied services commensurate with the individual’s training. One (1) to two (2) years of experience is preferred.Ability to work well collaboratively and across multidisciplinary teams. Demonstrate a special interest in community medicine.The ability to speak and write English fluently. Bilingual (English/Spanish) preferred.Ability to relate to culturally diverse patients and community.Flexibility to work at any CCI location, as assigned.WORKING CONDITIONS:Proper and professional grooming is always expected.Prolonged periods of standing, bending or working at a desk on a computer.The ability to lift (up to 15lbs) is required. Work under stressful conditions within a controlled enclosed environment daily. The work environment involves exposure to potentially dangerous materials and situations that require extensive safety precautions and may include the use of protective equipment. ADA Category. In accordance with the American with Disabilities Act, it is possible that requirements may be modified to reasonably accommodate disabled individuals. However, no accommodation will be made which may pose serious health or safety risks to the employee or others or which impose undue hardships on the organization. OSHA Category 1. Clinical environment. Possibility of exposure to chemicals and infectious body fluids e.g., HPV, HIV, HEP C, HSV.
Job DescriptionJob DescriptionPOSITION SUMMARY:The Family Medicine Clinician provides direct patient care commensurate to their training and experience, and in collaboration with CCI staff members. The care provided is appropriate for an out-patient, primary care community health center with a multicultural, multilingual patient population.As a member of the health center’s integrated care team the Family Medicine Clinician will fulfill the following KEY FUNCTIONS AND RESPONSIBILITIES towards the provision of patient-centered, coordinated, patient care:Examine, diagnose, and treat patients.Provide treatment to minors with or without accompanying parents.Adhere to evidence-based medical guidelines and standards approved by CCI’s Board and Performance Improvement Committee.Complete electronic medical records in expected time frames.Participate in peer review and performance improvement activities and audits.Attend and participate in meetings and/or committees, as necessary and/or required by CCI.Participate in additional medical projects as assigned.May provide consultation to other providers at CCI.May instruct medical students and/or residents in procedures for diagnosis and treatment of diseases and injuries.Flexibility to work at any CCI location assigned.Working on-site is an essential duty for the job. Other duties or responsibilities as assigned by the Chief Medical Officer or designee.KNOWLEDGE, SKILLS, AND ABILITIES:Knowledge of the state and federal laws pertaining to medicine and to community health centers.Knowledge of the principles and practice of medicine (including preventive care and acute/chronic disease management).Knowledge of the structure and function of community health centers.Skill in communicating effectively with patients and their families.Skill in establishing and maintaining effective working relationships with other employees, patients, and the public.Computer skills required. Knowledge/experience with Electronic Medical Records (EMR) is a plus.Flexibility to work at different CCI locations.The ability to speak and write English fluently. Bilingual (English/Spanish) preferred. MINIMUM QUALIFICATIONS:Must be in possession of a valid license to practice medicine in the State of MD.Maryland CDS and DEA licenses.Current BLS/CPR certification.Board Certification preferred. Board eligibility is required.Demonstrate a special interest in community medicine.Ability to relate to culturally diverse patients and community.WORKING CONDITIONS:Proper and professional grooming is always expected.Prolonged periods of standing, bending or working at a desk on a computer.The ability to lift (up to 15lbs) is required. Work under stressful conditions within a controlled enclosed environment daily. The work environment involves exposure to potentially dangerous materials and situations that require extensive safety precautions and may include the use of protective equipment. ADA Category. In accordance with the American with Disabilities Act, it is possible that requirements may be modified to reasonably accommodate disabled individuals. However, no accommodation will be made which may pose serious health or safety risks to the employee or others or which impose undue hardships on the organization. OSHA Category 1. Clinical environment. Possibility of exposure to chemicals and infectious body fluids e.g., HPV, HIV, HEP C, HSV.
Job DescriptionJob DescriptionPOSITION SUMMARY:The Family Medicine Clinician provides direct patient care commensurate to their training and experience, and in collaboration with CCI staff members. The care provided is appropriate for an out-patient, primary care community health center with a multicultural, multilingual patient population.As a member of the health center’s integrated care team the Family Medicine Clinician will fulfill the following KEY FUNCTIONS AND RESPONSIBILITIES towards the provision of patient-centered, coordinated, patient care:Examine, diagnose, and treat patients.Provide treatment to minors with or without accompanying parents.Adhere to evidence-based medical guidelines and standards approved by CCI’s Board and Performance Improvement Committee.Complete electronic medical records in expected time frames.Participate in peer review and performance improvement activities and audits.Attend and participate in meetings and/or committees, as necessary and/or required by CCI.Participate in additional medical projects as assigned.May provide consultation to other providers at CCI.May instruct medical students and/or residents in procedures for diagnosis and treatment of diseases and injuries.Flexibility to work at any CCI location assigned.Working on-site is an essential duty for the job. Other duties or responsibilities as assigned by the Chief Medical Officer or designee.KNOWLEDGE, SKILLS, AND ABILITIES:Knowledge of the state and federal laws pertaining to medicine and to community health centers.Knowledge of the principles and practice of medicine (including preventive care and acute/chronic disease management).Knowledge of the structure and function of community health centers.Skill in communicating effectively with patients and their families.Skill in establishing and maintaining effective working relationships with other employees, patients, and the public.Computer skills required. Knowledge/experience with Electronic Medical Records (EMR) is a plus.Flexibility to work at different CCI locations.The ability to speak and write English fluently. Bilingual (English/Spanish) preferred. MINIMUM QUALIFICATIONS:Must be in possession of a valid license to practice medicine in the State of MD.Maryland CDS and DEA licenses.Current BLS/CPR certification.Board Certification preferred. Board eligibility is required.Demonstrate a special interest in community medicine.Ability to relate to culturally diverse patients and community.WORKING CONDITIONS:Proper and professional grooming is always expected.Prolonged periods of standing, bending or working at a desk on a computer.The ability to lift (up to 15lbs) is required. Work under stressful conditions within a controlled enclosed environment daily. The work environment involves exposure to potentially dangerous materials and situations that require extensive safety precautions and may include the use of protective equipment. ADA Category. In accordance with the American with Disabilities Act, it is possible that requirements may be modified to reasonably accommodate disabled individuals. However, no accommodation will be made which may pose serious health or safety risks to the employee or others or which impose undue hardships on the organization. OSHA Category 1. Clinical environment. Possibility of exposure to chemicals and infectious body fluids e.g., HPV, HIV, HEP C, HSV.
Job DescriptionJob DescriptionPOSITION SUMMARY:The Family Medicine Clinician provides direct patient care commensurate to their training and experience, and in collaboration with CCI staff members. The care provided is appropriate for an out-patient, primary care community health center with a multicultural, multilingual patient population.As a member of the health center’s integrated care team the Family Medicine Clinician will fulfill the following KEY FUNCTIONS AND RESPONSIBILITIES towards the provision of patient-centered, coordinated, patient care:Examine, diagnose, and treat patients.Provide treatment to minors with or without accompanying parents.Adhere to evidence-based medical guidelines and standards approved by CCI’s Board and Performance Improvement Committee.Complete electronic medical records in expected time frames.Participate in peer review and performance improvement activities and audits.Attend and participate in meetings and/or committees, as necessary and/or required by CCI.Participate in additional medical projects as assigned.May provide consultation to other providers at CCI.May instruct medical students and/or residents in procedures for diagnosis and treatment of diseases and injuries.Flexibility to work at any CCI location assigned.Working on-site is an essential duty for the job. Other duties or responsibilities as assigned by the Chief Medical Officer or designee.KNOWLEDGE, SKILLS, AND ABILITIES:Knowledge of the state and federal laws pertaining to medicine and to community health centers.Knowledge of the principles and practice of medicine (including preventive care and acute/chronic disease management).Knowledge of the structure and function of community health centers.Skill in communicating effectively with patients and their families.Skill in establishing and maintaining effective working relationships with other employees, patients, and the public.Computer skills required. Knowledge/experience with Electronic Medical Records (EMR) is a plus.Flexibility to work at different CCI locations.The ability to speak and write English fluently. Bilingual (English/Spanish) preferred. MINIMUM QUALIFICATIONS:Must be in possession of a valid license to practice medicine in the State of MD.Maryland CDS and DEA licenses.Current BLS/CPR certification.Board Certification preferred. Board eligibility is required.Demonstrate a special interest in community medicine.Ability to relate to culturally diverse patients and community.WORKING CONDITIONS:Proper and professional grooming is always expected.Prolonged periods of standing, bending or working at a desk on a computer.The ability to lift (up to 15lbs) is required. Work under stressful conditions within a controlled enclosed environment daily. The work environment involves exposure to potentially dangerous materials and situations that require extensive safety precautions and may include the use of protective equipment. ADA Category. In accordance with the American with Disabilities Act, it is possible that requirements may be modified to reasonably accommodate disabled individuals. However, no accommodation will be made which may pose serious health or safety risks to the employee or others or which impose undue hardships on the organization. OSHA Category 1. Clinical environment. Possibility of exposure to chemicals and infectious body fluids e.g., HPV, HIV, HEP C, HSV.
Job DescriptionJob DescriptionPosition Summary:The Patient Coverage Verification Specialist (PCVS) is responsible for providing the highest level of customer service to CCI patients and CCI staff. They will verify all patient dental, medical, and behavioral health coverages and benefits for scheduled appointments. Provide clear documentation regarding insurance coverage and any authorizations that may be needed for the appointment, in our practice management system. They are responsible for supporting CCI’s efforts to capture the maximum payment for services rendered. They will also reach out to patients who do not have insurance for appointments to inform them of coverage options.KEY FUNCTIONS AND RESPONSIBILITIES: Clearly, effectively, and efficiently engages with patients, representatives, care givers, care team, and MCO’s to ensure accuracy and timeliness of communication and transfer of information needed for preauthorization, billing and payment.Verify eligibility, coverage, and benefits for all scheduled patients.Reviews, tracks and follow-up on all preauthorization requests to MCO’s and providers.Provides prompt, efficient and personalized assistance to meet the requirements, requests, and coverage needs of patientsIdentifies patients’ coverage needs, issues and works to mitigate and resolve any issues prior to arrival for their appointment.Explains basic insurance terminology and procedures related to the patient obtaining care from the providers.Receive, review, and respond to telephone and written inquiries.Enter and update patient information into EMR – i.e., document services by initiating appropriate forms, entering client data into the EMR and ensuring all documentation is appropriately signed and dated.Complies with all federal and local patient privacy laws to ensure patient confidentiality – i.e., HIPPA.Determines any copays/coinsurance/deductible amounts that are patient responsibility and makes notes in EMR’s appointment comment field for the Patient Representative to collect.Verifies coverage for appointments two (2) days ahead. Ensures Medicaid is verified at the beginning of every month and works to get caught back up to the two-day window of coverage verification as applicable.Arranges treatment authorizations from MCO’s when needed for payment, and tracks authorizations and notifies providers when a new authorization is needed as applicable to payer.Confirm patient insurance coverage prior to initial appointment and documents benefits for all new insurances in EMR.
MINIMUM QUALIFICATIONS:High School, G.E.D or equivalent required. Bachelor's degree a plus.One (1) year of related customer service and medical coverage verification experience required.Certification in Medical Billing and Coding a plus.Strong written, interpersonal, and telephone communication skills.Must be attentive to detail and time sensitive to meeting deadlines.One year of customer service experience and coverage verification experience requiredProficiency with Electronic Medical Records (EMR) System. Experience with eCW preferred.Prior FQHC experience a plus.Must be professional and customer focused.Must be able to work effectively and efficiently both independently and within a team.Bilingual preferred.
WORKING CONDITIONS:Proper and professional grooming is always expected.Prolonged periods of standing, bending or working at a desk on a computer.The ability to lift (up to 15lbs) is required. Ability to work in a fast-paced, controlled/enclosed, and complex environment.Potential exposure to materials and situations that require extensive safety precautions and may include the use of protective equipment.
