8hrs a day with 1hr unpaid break
Schedule: To be determined (within client's business hours)
Position Summary The Bilingual QI-Medical Receptionist supports the company's Quality Improvement initiatives and front-office operations in a remote capacity. This hybrid role blends administrative precision with compassionate member engagement, ensuring seamless coordination between patients, providers, and internal teams. The ideal candidate is detail-oriented, tech-savvy, and committed to maintaining high standards of compliance, privacy, and productivity while working remotely.
Key Responsibilities
Receptionist Duties
- Answer incoming calls, route messages, and manage ULTATEL TEXT Message systems professionally
- Schedule appointments, transportation, follow-up on GA food requested
- Provide courteous, bilingual communication to members and providers
- Maintain accurate documentation in SwyftOps systems and ensure timely data entry
Quality Improvement Support
- Track and report care gaps, HEDIS measures, and Chart Audits
- Support QI initiatives by assisting with chart audits, care plan reviews, and compliance checklists
- Communicate with providers and case managers to ensure documentation accuracy and care gaps are being addressed
- Assist with referrals, authorizations, and coordination of specialty services
Program knowledge
- Understand the company's Enhanced Care Management (ECM) model, including eligibility, referral workflows, and service offerings.
- Support member onboarding by explaining ECM benefits, care coordination goals, and available resources in both English and Spanish.• Assist with Outreach & Referral (OR) processes, ensuring timely follow-up and accurate documentation of member engagement.
- Maintain working knowledge of Medi-Cal guidelines, CalAIM initiatives, and company's interdisciplinary care approach.
- Participate in ongoing training to stay current on program updates, compliance standards, and QI metrics.
Remote Work Compliance
- Maintain a secure, quiet, and ergonomically appropriate home office environment
- Log in daily via Teams by 8:15 AM (PST) and attend scheduled huddles or meetings
- Submit daily productivity reports and categorized schedules to supervisor by end of day (tracking report)
- Ensure HIPAA-compliant handling of PHI—no public or shared spaces permitted
- Follow company's password and data security protocols, including locked storage and regular password updates
- Limit personal tasks to designated breaks and lunch periods
Qualifications
- High school diploma and an Associate degree in Business Administration, Healthcare, or related field preferred
- Minimum 2 years of experience in medical reception, care coordination, or QI support
- Fluent in English and Spanish (written and verbal)
- Basic understanding of medical terminology and healthcare services
- Proficient in EMR systems, Microsoft Teams, and Excel and remote communication tools
- Strong understanding of HIPAA, HEDIS, and MEDI-CAL documentation standards
- Exceptional organizational skills and attention to detail
- Ability to work independently while maintaining accountability and productivity
Technical & Environmental Requirements
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Reliable high-speed internet connection
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Secure workstation with proper lighting, ventilation, and minimal noise
- Access to locked file storage and password-protected devices
- Willingness to comply with company's IT and security protocols
Independent Contractor Perks
Health Insurance coverage for eligible locations
Permanent work from home
Immediate hiring
Steady freelance job