Pay for Performance Specialist

The position is responsible for assisting the Director of Pay for Performance Program in organizing and monitoring the Pay for Performance Program offered through a variety of medical insurance carriers.

• Reviews patient’s electronic health record and abstracts statistical and clinical data from the patient’s visit.
• Supports the Director of Pay for Performance Program with the organization and management of a tracking system for all expected Pay for Performance (PFP) and incentive programs to ensure efficient daily operation.
• Assists with assessing patient data to identify strategies or sources of revenue.
• Works collaboratively with DVCH staff to resolve incompleteness of Pay for Performance forms or other revenue enhancement issues identified.
• Identifies and assists with scheduling appointments for patients identified with Care Gaps from member panels that have not been seen in the current year.?
• Manages reports sent in by insurance carriers for “Transition of Care” purposes and communicates with health center managers to ensure appointments are made for follow-up provider visits.
• Ensures tracking of all Pay for Performance forms sent to providers and various other locations.
• Assists with the preparation of monthly/quarterly reports that track the revenue generated from Pay for Performance and incentive programs.
• Participates in webinars/meetings with insurance carriers as requested to remain current on changing issues impacting the Pay for Performance and incentive programs. Communicates pertinent information to the Director of Pay for Performance Program.
• Answers telephone calls, relays messages, and responds to inquiries when possible.
• Maintains filing system and files all correspondence and Pay for Performance paperwork.
• Performs general duties such as making copies, faxing, handling mail, and sending correspondence as assigned.

• A high school diploma or equivalent is required.
• Associates degree preferred.
• Training as a medical assistant with minimum of 2 years clinical experience preferred.
• Knowledge of medical insurance and billing is preferred.
• Proficient with Excel and Word applications required.
• Knowledge of medical terminology is highly preferred.
• Must possess good analytical skills and the ability to maintain an effective and organized tracking system.
• An understanding of electronic health records is preferred.

Tuition reimbursement, Health insurance, 401(k) matching, Paid time off, Vision insurance, Health savings account, Dental insurance, Flexible spending account Full-time Monday to Friday 1412 Fairmount Avenue, Philadelphia, PA 19130

Full job description

Pay for Performance Specialist Philadelphia, PA Mon-Fri Benefits:

• Medical, Vision, & Dental Insurance w/ HSA & FSA options
• 401k w/ Match and other contributions
• Employer paid Life Insurance, Short-Term and Long-Term Disability Insurances
• Tuition Reimbursement
• Generous Paid Time Off
• Room for growth and development

For over 55 years, Delaware Valley Community Health has been driven by our mission to serve the underserved population of Greater Philadelphia. We feel there is no greater cause than helping those in need, and we welcome all who share in our beliefs to consider joining us. At DVCH, there’s a lot of humanity in our workplace. We support each other in a friendly, dynamic, and diverse environment and treat each other like family. The work is often challenging but it’s always rewarding. We are committed to giving our people every opportunity to succeed. We believe that investing in our employees is the right thing to do by providing quality benefits and continuous learning opportunities to enhance the professional and personal lives of our team members. If you are eager to realize your true potential while helping those in need, we invite you to explore a career with purpose, and join our family at Delaware Valley Community Health.