Spanish Bilingual Virtual QI-Medical Receptionist

This is a remote position.

• Monday to Friday 8 AM - 5 PM PST 

• Answer incoming calls, route messages, and manage ULTATEL TEXT Message systems professionally
• Schedule appointments, transportation, follow-up on GA food’s requested
• Provide courteous, bi-lingual communication to members and providers
• Maintain accurate documentation in SwyftOps systems and ensure timely data entry

• 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

• Understand BLEHEALTH’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 interdisciplinary care approach.
• Participate in ongoing training to stay current on program updates, compliance standards, and QI metrics.

• 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 client's password and data security protocols, including locked storage and regular password updates
• Limit personal tasks to designated breaks and lunch periods

• High school diploma and 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

• Reliable high-speed internet connection
• Secure workstation with proper lighting, ventilation, and minimal noise
• Access to locked file storage and password-protected devices
• Willingness to comply with client's IT and security protocols

Independent Contractor Perks

• HMO Coverage for eligible locations
• Permanent work-from-home
• Immediate hiring