Geisinger

Customer Support

• Resolve and reconcile enrollment reports and related eligibility issues according to policies, procedures, and state coverage and eligibility guidelines
• Initiate communication and literature for newly enrolled Health Plan members, dependents, and employer groups
• Interpret and apply rules and regulations in contractual agreements with employer groups and vendors
• Perform membership data extract reports for employer group audit and compliance purposes
• Update, approve, and interpret membership data and workflow in employer group modules
• Determine member eligibility and process terminations and disenrollments
• Prepare and disseminate letter communications regarding enrollment activity
• Determine whether services are covered benefits based on line of business and product design
• Review suspended claims and resolve issues using applicable policies, procedures, and benefits
• Support member and provider services staff with claims resolution policies and procedures
• Provide daily support and advice regarding claims issues
• Research provider claim issues and identify criteria for payment reconsideration
• Participate in cross-training and process improvement within the Customer Service team

Customer Service Representative I – Enrollment

Physician

• Join Geisinger Women’s Health Northeast in Scranton, Pennsylvania
• Provide a balance of obstetrics and gynecology care
• See 15–20 patients per day
• Work within a large group of 10 physicians and 21 advanced practice providers
• Participate in a practice with 24-hour laborist coverage
• Collaborate with midwives available 12 hours per day
• Participate in teaching opportunities

OBGYN Physician

Operations

• Supervise, develop and manage a team of Customer Service Representatives
• Ensure customer service standards, accreditation and regulatory requirements are met
• Serve as a resource for communication and access to services for staff, members, providers, employers and other organizational customers
• Report and trend customer issues
• Review, develop and provide ongoing training and educational tools to staff
• Assist with site visits and direct and control Customer Service activities
• Manage customer inquiries for accurate and timely completion
• Analyze production and quality metrics and recommend staffing, policy or process changes
• Resolve complaints according to complaint complexity, governmental requirements and organizational policies
• Handle escalated customer issues requiring management intervention
• Provide leadership and developmental assistance through daily interactions and monthly one-on-one meetings
• Conduct monthly team meetings and involve staff in decision-making
• Recognize and reward staff achievement
• Create and maintain operational standards and performance measurement tools
• Manage resource allocation, staffing levels and schedules
• Manage outbound call campaigns for member education and retention
• Perform supervisory duties including attendance monitoring, performance evaluations and disciplinary actions
• Interview and select prospective employees
• Handle Human Resource issues including Performance Improvement Plans, interpersonal issues and leave requests
• Support Customer Service personnel and other departments in problem resolution
• Define and support goals, policies and procedures
• Participate in and lead interdepartmental strategic teams
• Ensure regulatory compliance, including Federal Medicare Advantage processes and prompt payment provisions
• Provide input in budget preparation
• Process accurate adjudication and payment of claims

Supervisor – Enrollment Operations

• Join a robust team of OBGYN physicians, Laborists, Midwives and Advanced Practice Providers
• Provide a balance of obstetrics and gynecology care
• Participate in clinic every other business day, approximately 11 days per month
• Complete five days of on-call per month with 24-hour shifts and a recovery day following call
• Work alongside midwives available 12 hours per day
• Provide care in a setting averaging 2,000 deliveries per year, supported by a level III NICU
• Serve patients at Geisinger Community Medical Center in Scranton, Pennsylvania

Business Intelligence Developer

• Serve as a subject matter expert in Medicare 5-star methodology
• Partner directly with business and clinical stakeholders
• Consult with stakeholders to gather project requirements and define scope
• Collaborate on analytic studies and reporting solutions
• Plan projects and request-completion tasks
• Provide time and effort estimates
• Manage multiple projects independently
• Learn and maintain working knowledge of relevant source systems and business intelligence software
• Lead analysis approaches and reporting based on business questions and findings
• Develop, validate, and execute complex queries for sophisticated data analysis
• Interpret results and make recommendations based on findings
• Lead efforts involving multiple analysts
• Present analyses and reports to internal customers and stakeholders
• Mentor junior analysts through feedback, code reviews, presentations, training, and development opportunities
• Use statistical methods and appropriate data visualizations
• Report and troubleshoot data-quality issues during profiling, testing, and validation
• Participate in and advise strategic departmental initiatives
• Potentially lead industry advisory and/or user groups
• Share information, provide resources, volunteer for assignments, and remove barriers to team goals
• Follow department policies and procedures, including request intake/fulfillment, change management, and data governance
• Work is typically performed in an office environment

Business Intelligence Analyst Lead, Medicare

Social Worker

• Assess patient needs and abilities and develop treatment plans to improve patient functioning and resolve symptoms
• Provide individual, family, couple, and group psychotherapy as clinically appropriate
• Participate in program planning with the psychiatry team and other applicable team members
• Evaluate patients' ongoing biopsychosocial needs, identify problems, and determine treatment plans
• Provide psychotherapy and case management to assigned patients
• Provide input regarding the care of program patients
• Serve as primary therapist or co-therapist in group therapy for psychiatric patients
• Serve as primary therapist in individual, family, and couple therapies
• Obtain pertinent data in accordance with program and regulatory standards
• Uphold agency policies, standards, and ethical standards of the appropriate discipline
• Collaborate with outpatient and inpatient teams to provide triage evaluation and crisis intervention
• Comply with job-specific obligations and organization policies and procedures

Licensed Clinical Social Worker – Outpatient Pediatrics

Counselor

• Assess patient needs and abilities and develop treatment plans to improve patient functioning and resolve symptoms
• Provide individual, family, couple, and group psychotherapy as clinically appropriate
• Participate in program planning with the psychiatry team and other applicable team members
• Evaluate patients' ongoing biopsychosocial needs and determine treatment plans
• Provide psychotherapy and case management to assigned patients
• Provide input regarding the care of program patients
• Serve as primary therapist or co-therapist in group therapy for psychiatric patients
• Serve as primary therapist in individual, family, and couple therapies
• Obtain pertinent data in accordance with program and regulatory standards
• Uphold agency policies, organizational standards, and ethical standards of the discipline
• Collaborate with outpatient and inpatient teams to provide triage evaluation and crisis intervention
• Work in a clinical environment and comply with organization policies and procedures

Licensed Professional Counselor – Outpatient Pediatrics

General

• Support the Strategic HR Partner as the disability and accommodation Center of Excellence subject matter expert across the enterprise
• Drive HR excellence across service lines in disability programs and accommodation management
• Analyze data and summarize observations, trends and gaps related to disability and accommodation management
• Communicate with employees with accommodation needs to facilitate smooth and timely return to work
• Relay communication between employees and managers for complex disability-related accommodation requirements or escalations
• Partner with Worker’s Compensation, Risk Management and other departments
• Receive, review and guide leaders and employees on accommodation requests under the Americans with Disabilities Act
• Research available accommodations and review options as part of the interactive process
• Draft and recommend revisions to company policies for compliance with federal, state and local laws and regulations
• Maintain complete and accurate records of leave and accommodation requests
• Identify and develop transitional return-to-work programs and temporary modified jobs
• Work with supervisors to adjust workplace accommodations within return-to-work programs
• Educate department heads on successful return-to-work programs and best practices
• Mentor departments and explore return-to-work opportunities by suggesting potential modified jobs
• Identify critical job functions employees must perform with or without accommodation
• Create, update and provide organization-wide education related to the subject matter
• Maintain expertise on regulatory changes and interpret and apply relevant laws, regulations, codes and standards
• Recommend work-environment changes based on legal interpretations and professional practices

Disability and Accommodation Specialist – PA Resident

Nurse

• Work as an LPN supporting a Nursing In-basket across 11 Geisinger Community Medicine locations
• Provide primary clinical support to providers, patients, and families in diagnosis and treatment
• Follow up on diagnostic testing for completion, accuracy, and medical-record filing
• Maintain a clean clinical environment
• Obtain and document medical history, chief complaint, and vital signs
• Prepare patients for examinations
• Provide direct clinical care as directed by the provider
• Assist with minor surgical diagnostic procedures and ancillary diagnostic examinations
• Collect laboratory specimens and complete associated paperwork
• Execute and document patient communications; prioritize issues for providers and respond to patient questions
• Administer medications and vaccines, including intradermal and skin testing, under provider direction and within scope of practice
• Clean and set up examination and treatment rooms, ensuring asepsis and availability of instruments and equipment

Licensed Practical Nurse – Regional In-Basket

• Resolve customer concerns and provide appropriate education and instruction
• Maintain customer satisfaction and provide a high level of customer service
• Develop proficiency in two or more specialties for one line of business
• Participate in cross-training and improve Customer Service team processes
• Provide guidance on complex issues to customer service representatives
• Manage complex caseloads while meeting production and quality standards
• Organize and distribute work to staff members
• Liaise between members and providers to resolve claims, benefit, and eligibility concerns
• Serve as the primary contact for members, providers, and co-workers
• Maintain member and provider relationships through telephone contact, written correspondence, and on-site visits
• Investigate concerns and issues to ensure accurate information is provided
• Resolve member and provider concerns and inquiries
• Establish and maintain member and provider relations
• Respond to web requests and emails from internal and external contacts as required

Customer Service Representative I – Commercial Enrollment

Physician Assistant

• Provide direct patient care and clinical support for physicians and other outpatient providers
• Obtain and document patient visit information, vital signs, screenings, medication reviews, and pertinent data in the electronic medical record
• Prepare examination and treatment rooms between cases and patients
• Assist patients with visit preparation while ensuring safety and privacy
• Perform EKGs, wound dressings, minor procedure support, and ancillary examination support
• Prepare and administer medications according to policy and validated competency; do not administer intravenous medications
• Complete provider-ordered tests and treatments
• Collect and prepare laboratory specimens and complete associated paperwork
• Perform phlebotomy and assist with laboratory functions under laboratory oversight
• Perform receptionist, scheduling, filing, referral, pre-authorization, billing, and other clerical duties
• Maintain complete and accurate medical records using electronic medical record and scheduling systems
• Facilitate timely patient appointments and collect co-payments
• Assist with orientation of new personnel
• Manage patient communications, prioritize provider messages, and respond to patient questions and requests
• Reinforce patient education as directed by providers
• Inventory non-controlled medical/surgical supplies and pharmaceuticals as needed
• Prepare and clean instruments and follow sterilization, disinfection, and infection prevention protocols
• Inspect diagnostic equipment and instrumentation and identify maintenance needs
• Participate in patient safety and quality improvement programs
• Travel between clinic locations as required

Certified Medical Assistant – CMA

• Provide direct patient care and clinical support for physicians and other outpatient providers
• Prepare patients and collect, review, and document pertinent information in the electronic medical record
• Obtain and document reasons for visit, weight, vital signs, screening information, medication reviews, and other clinical information
• Set up examination and treatment rooms between cases
• Assist patients with visit preparation while protecting safety and privacy
• Perform EKGs, wound dressings, minor surgical procedure support, and ancillary examination support
• Prepare and administer medications according to policy and validated competency; do not administer intravenous medications
• Complete provider-ordered tests and treatments
• Collect and prepare laboratory specimens and complete related paperwork
• Perform phlebotomy and assist with laboratory testing, reporting, and quality assurance
• Perform receptionist and clerical duties, including filing medical and ancillary reports
• Maintain complete and accurate medical records
• Use electronic medical record and scheduling systems
• Facilitate appointments, referrals, and pre-authorizations
• Collect co-payments
• Assist with orientation of new personnel under provider or site lead direction
• Manage patient communications, prioritize provider messages, and respond to patient questions and requests
• Reinforce provider-directed patient education
• Inventory non-controlled medical/surgical supplies and pharmaceuticals as needed
• Access and transport non-controlled medications as necessary
• Prepare and clean instruments and follow sterilization and disinfection protocols
• Clean and set up examination rooms using infection prevention protocols
• Follow hand hygiene and infection prevention precautions
• Inspect diagnostic equipment and instrumentation and identify maintenance needs
• Participate in patient safety and quality improvement programs
• Travel between locations as required

• Provide telephone, email, and web submission support for customer-facing portals
• Serve as the main point of contact for portal users
• Deliver exceptional customer service, troubleshooting, and user technical support
• Receive customer calls and communications courteously
• Accurately document inquiries and concerns
• Record incident or request details and actions taken in the call ticketing system
• Assess issue impact and urgency and assign priority according to standards
• Attempt first-touch resolution using documented solutions or workarounds
• Answer customer questions and assist with issues
• Determine the correct path for permanent solutions and route tickets according to protocol
• Notify customers of scheduled and unscheduled disruptions using approved communication methods
• Participate in creating or updating documentation
• Communicate and coordinate with internal departments to resolve customer concerns and issues
• Manage critical or major impact incidents while following established protocol
• Follow up on issues requiring further research
• Escalate issues to second-tier support as needed

Digital Customer Support Associate

• Serve in an expanded nursing role within an interdisciplinary team to promote preventative patient care, provide screening services, and coordinate disease management
• Provide primary clinical support to providers, patients, and families in diagnosis and treatment
• Triage inbasket messaging and manage patient interactions with the clinic
• Identify patient needs, intervention pathways, clinical guidelines, and diagnostic tests to develop individualized care plans
• Assess healthcare, educational, and psychosocial needs of patients and families and involve them in treatment planning
• Investigate healthcare options and facilitate communication among patients, primary care providers, and healthcare teams
• Educate patients, families, and healthcare members on care coordination, disease, and case management programs
• Serve as a disease-management resource to patients, families, and healthcare team members
• Implement clinical interventions based on risk stratification and evidence-based guidelines
• Collaborate with providers to improve guideline adherence, initiate or adjust therapies as directed, and provide follow-up monitoring
• Coordinate laboratory and diagnostic testing for disease management programs
• Maintain required documentation in EPIC
• Collect and enter patient data according to department standards
• Participate in professional and nursing continuing education and development opportunities
• Review literature and incorporate effective teaching, learning, and disease-management strategies
• Maintain involvement in post-discharge Transitions of Care coordination
• Assist leadership with designing, implementing, and evaluating care coordination programs
• Collect and prepare laboratory specimens and complete related paperwork
• Insert, monitor, regulate, and discontinue IVs as required
• Administer medications and vaccines, including intradermal and skin testing, under provider direction and within scope of practice

RN – Registered Nurse Coordinator, Primary Care

Financial Planning and Analysis

• Coordinate, oversee, and prepare financial analysis supporting business processes, accounting, revenue enhancement, expense management, and issue resolution
• Identify opportunities for revenue enhancement, expense management, and process improvements
• Develop financial tools and templates supporting business processes, analytical capabilities, and activity tracking
• Maintain documentation of analytical processes and targets
• Ensure all work is performed in an auditable fashion
• Review, refine, and automate department procedures to improve workflow efficiency
• Develop finance and business partner relationships to understand needs and provide actionable analysis
• Analyze productivity, clinical throughput, and operational efficiency across hospital and clinic settings
• Develop and maintain dashboards, scorecards, and reports tracking KPIs such as patient volumes, cost per encounter, and contribution margins
• Utilize Vizient benchmarking tools to assess performance against peers and identify improvement opportunities
• Collaborate with clinical, operational, and executive leadership to interpret data
• Conduct variance analysis and root cause investigations related to performance and service line profitability
• Present findings clearly and concisely to financial and non-financial stakeholders
• Travel may be required; comply with job-specific obligations and organizational policies and procedures

Customer Service Representative I – Enrollment

OBGYN Physician

Supervisor – Enrollment Operations

OBGYN Physician

Business Intelligence Analyst Lead, Medicare

Licensed Clinical Social Worker – Outpatient Pediatrics

Licensed Professional Counselor – Outpatient Pediatrics

Disability and Accommodation Specialist – PA Resident

Licensed Practical Nurse – Regional In-Basket

Customer Service Representative I – Commercial Enrollment

Certified Medical Assistant – CMA

Certified Medical Assistant – CMA

Digital Customer Support Associate

RN – Registered Nurse Coordinator, Primary Care

Senior Financial Analyst