Claims & Medical Administrator

Job Details

Job summary

 

Claims & Medical Administrator, Suffolk Primary Care

We are Suffolk Primary Care, a Partnership of 8 GP Practices that delivers care to 90,000 patients across Suffolk.

We are seeking an experienced Claims & Medical Administrator to join our fabulous team supporting the contractual claims work for our GMS & PMS practices and support our existing teams.

We are a friendly, innovative and exciting GP partnerships which prides itself on outstanding patient care, excellent access and good systems to support our clinicians.

Suffolk Primary Care have an excellent record of working collaboratively to deliver quality care to our patients. The successful candidate needs to be highly organised with a high level of attention to detail and a proven ability to work to deadlines. Excellent communication is essential, and to be able to work effectively as part of a team. We are looking for a candidate with Primary Care experience, if this sounds like you, then we would love to hear from you.

 

You will be working for an organisation focused on developing and nurturing staff and delivering excellent quality of care to our patients.

We are ideally looking for the position to be filled full time with the hours being Mon-Fri 9am-5pm but part time candidates will be considered. Shortlisting will be on 18th December with Interviews on 4th & 5th January. The interview panel will consist of a minimum of 2 people.

 

Main duties of the job

 

  • Collation of contractual claims on a monthly, quarterly and annual basis as indicated by contract schedules. To include the following:
    • GMS Contract
    • PMS Contract
    • Local Enhanced Services (LES)
    • Direct Enhanced Services (DES)
    • Public Health
    • Personally Administered Items (non-dispensing sites)
    • Any additional contractual income streams
  • Use SystmOne reports, CQRS and other reporting templates required for submission of claims
  • Ensure all contractual claim requirements are complete, report this data using local and national online claim portals
  • To liaise with ICB and NHS England colleagues and provide evidence when required
  • To liaise with site clinical and operational staff for additional data/evidence if required

 

About us

SPC is an innovative partnership of Suffolk GP surgeries.

Doctors and practice staff share resources and work together to ensure patients continue to receive high quality healthcare.

Suffolk Primary Care is committed to a policy of equal opportunities in employment. Applicants will ideally be fully vaccinated against Covid.

Benefits of working for SPC include:

NHS Pension Scheme

The NHS Pension Scheme is a defined benefits scheme

Life insurance

Family benefits including an adult dependents pension and childrens pension

Ill health benefits

20% employer contribution

Electric Car Salary Sacrifice Scheme

No deposit

No credit check

Fully comprehensive insurance

Servicing and tyres

Breakdown cover

Up to £2,000 contribution from SPC subject to conditions

Proper Pay & Cost of Living Benefits

Living Wage Foundation Accredited

GP Remote Working

Eye Care Vouchers Health Service Discounts

Annual Leave – Minimum 33 days including bank holidays FTE with enhancements for long service

Enhanced Maternity & Paternity terms

High street discounts through our own online portal

Technology and Homewares Salary Sacrifice schemes with Currys and John Lewis

Cycle to Work Salary Sacrifice Scheme

Gym Salary Sacrifice Scheme

Job description

Job responsibilities

Job Summary

The main responsibilities of the post holder will be to ensure timely and accurate collation of monthly contractual claims for Suffolk Primary Care sites.

Working as part of a team, the post holder will be responsible for allocated sites, but also support the team to ensure the contractual claims are completed for Suffolk Primary Care.

The post holder will also be responsible for completing work with the Medical Administration Team

Key Responsibilities

Claims

  • Collation of contractual claims on a monthly, quarterly and annual basis as indicated by contract schedules. To include the following:
    • GMS Contract
    • PMS Contract
    • Local Enhanced Services (LES)
    • Direct Enhanced Services (DES)
    • Public Health
    • Personally Administered Items (non-dispensing sites)
    • Any additional contractual income streams
  • Use SystmOne reports, CQRS and other reporting templates required for submission of claims
  • Ensure all contractual claim requirements are complete, report this data using local and national online claim portals
  • To liaise with ICB and NHS England colleagues and provide evidence when required
  • To liaise with site clinical and operational staff for additional data/evidence if required
  • Interrogate data on SystmOne to check the practice is not missing available income
  • To undertake clinical reporting, audits and produce statistics as requested
  • Undertaking other reasonable duties within the framework of the post as directed by the Business Intelligence Manager / Practice Operations Manager / Partners

Medical Administrator

  • Transferring and processing electronic discharges from the NHS mail to pdf format
  • Transferring and processing discharges and clinic letters received via tasks
  • Scanning and processing hard copy letters
  • Code relevant information onto the clinical system to include relevant QOF data and clinical information following the Suffolk Primary Care Clinical Correspondence Coding Protocol
  • Administration of long-term condition recalls following the agreed Suffolk Primary Care Protocol
  • To undertake Quality Outcome Framework (QOF) work where required following the agreed Suffolk Primary care Protocol
  • To work across Suffolk Primary Care sites to provide cover and additional support where required
  • Undertaking other reasonable duties within the framework of the post as directed by the Practice Operations Manager / Partners

Person Specification

Qualifications

Essential

  • GCSE grade A to C in English and Maths

Experience

Essential

  • Experience of working within primary care

Desirable

  • Knowledge of NHS contracts and claims
  • Knowledge of medical terminology

Disclosure and Barring Service Check

This post is subject to the Rehabilitation of Offenders Act (Exceptions Order) 1975 and as such it will be necessary for a submission for Disclosure to be made to the Disclosure and Barring Service (formerly known as CRB) to check for any previous criminal convictions.

 

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