Quality Management Specialist I (Abq)
By Blue Cross and Blue Shield of Illinois, Montana, New Mexico, Oklahoma & Texas At Albuquerque, NM, United States
Quality improvement and/or project management experience.
3 years clinical practice experience.
Verbal and written communication skills.
Registered Nurse (RN) with current, unrestricted license to practice in the state of operations (New Mexico).
Ability to travel (about 20% to Provider Offices/Facilities) including overnight stays.
PC proficiency to include Word and Excel.

Are you looking for an exciting opportunity to use your medical management skills to make a difference? We are looking for a Medical Management Specialist I to join our team and help us provide the best care possible to our patients. You will be responsible for managing patient records, coordinating care plans, and ensuring compliance with all applicable regulations. If you have a passion for healthcare and are ready to take on a challenging role, this could be the perfect job for you!

Overview Medical Management Specialists I are responsible for providing administrative and clinical support to healthcare providers and medical staff. They are responsible for managing medical records, scheduling appointments, and providing patient education. They also provide support to medical staff in the areas of coding, billing, and reimbursement. Detailed Job Description Medical Management Specialists I are responsible for providing administrative and clinical support to healthcare providers and medical staff. They are responsible for managing medical records, scheduling appointments, verifying insurance coverage, and providing patient education. They also provide support to medical staff in the areas of coding, billing, and reimbursement. They may also be responsible for coordinating patient care and providing assistance with medical claims. Job Skills Required
• Knowledge of medical terminology, coding, and billing
• Excellent organizational and communication skills
• Ability to multitask and prioritize tasks
• Ability to work independently and as part of a team
• Knowledge of medical office procedures
• Proficiency in Microsoft Office applications
Job Qualifications
• High school diploma or equivalent
• Associate’s degree in medical office management or related field preferred
• Previous experience in a medical office setting preferred
Job Knowledge
• Knowledge of medical terminology, coding, and billing
• Knowledge of medical office procedures
• Knowledge of insurance plans and reimbursement
Job Experience
• Previous experience in a medical office setting preferred
Job Responsibilities
• Manage medical records and schedule appointments
• Verify insurance coverage and provide patient education
• Coordinate patient care and provide assistance with medical claims
• Provide administrative and clinical support to healthcare providers and medical staff
• Assist with coding, billing, and reimbursement processes