Job summary
Eastwood Primary Care Centre is looking for a highly organised and detail-orientated individual to be our Claims & Enhanced Services Coordinator. This role is essential in ensuring accurate processing of claims & supporting clinical teams. If you think you might be the right candidate, please get in touch.
Main duties of the job
We value precision, attention to detail and being able to work independently while being part of a supportive and patient-focused team.The successful candidate must have experience in a healthcare setting and it would be desirable for them to be familiar with clinical I.T. systems and claims processes.
The successful candidate will be responsible for managing and processing clinical claims, including Prescribing Authority (FP34D), minor surgery, implants, and ring pessary claims. You will oversee enhanced services administration (such as PSA, anticoagulation, ADHD, and other specialist services), maintain accurate CQRS submissions for immunisations and other programs, and support QOF target achievement. Additional duties include ordering clinical stock, coordinating patient invitations for shingles and pneumonia, monitoring safety alerts, producing reports for the nursing team, and managing waiting lists for obesity services. Strong organisational skills and attention to detail are essential for this role.
About us
Eastwood Primary Care Centre offers a supportive and forward-thinking environment. By joining our team, you will contribute directly to improving clinical efficiency, ensuring accurate and up-to-date records, and supporting clinicians with timely and relevant information.
Job description
Job responsibilities
Main Duties and Responsibilities- Claims Management
- Process and submit PA claims (FP34D), minor surgery, implant, and ring pessary claims.
- Enhanced Services Administration
- Manage claims for services including PSA, anticoagulation, DMARD, ADHD, SMI, communication adjustments, asylum seekers, eating disorders, and other specialist programs.
- CQRS Submissions
- Accurately record and submit claims for immunisations and services such as:
- Childhood and adult vaccinations (6-in-1, seasonal flu, HepB, HPV, MenACWY, MMR, Pertussis, PPV, Pneumococcal, RSV, Rotavirus, shingles).
- Weight management and learning disabilities.
- Quality Outcomes Framework (QOF)
- Support the clinical team in achieving QOF targets.
- Stock Management
- Order PA stock, dressings, and injections for minor operations and implants.
- Manage Sanofi orders (Typhim and Revaxis).
- Patient Communication
- Coordinate shingles and pneumonia invitations.
- Safety & Compliance
- Monitor and action safety alerts promptly.
- Reporting
- Produce reports for the nursing team and maintain accurate records.
- Obesity LES
- Manage waiting lists and add patients for nursing team follow-up.
Job description
Job responsibilities
Main Duties and Responsibilities- Claims Management
- Process and submit PA claims (FP34D), minor surgery, implant, and ring pessary claims.
- Enhanced Services Administration
- Manage claims for services including PSA, anticoagulation, DMARD, ADHD, SMI, communication adjustments, asylum seekers, eating disorders, and other specialist programs.
- CQRS Submissions
- Accurately record and submit claims for immunisations and services such as:
- Childhood and adult vaccinations (6-in-1, seasonal flu, HepB, HPV, MenACWY, MMR, Pertussis, PPV, Pneumococcal, RSV, Rotavirus, shingles).
- Weight management and learning disabilities.
- Quality Outcomes Framework (QOF)
- Support the clinical team in achieving QOF targets.
- Stock Management
- Order PA stock, dressings, and injections for minor operations and implants.
- Manage Sanofi orders (Typhim and Revaxis).
- Patient Communication
- Coordinate shingles and pneumonia invitations.
- Safety & Compliance
- Monitor and action safety alerts promptly.
- Reporting
- Produce reports for the nursing team and maintain accurate records.
- Obesity LES
- Manage waiting lists and add patients for nursing team follow-up.
Person Specification
Qualifications
Essential
- GCSE grade A to C in English and Maths (minimum).
- Strong organisational and administrative skills.
- Excellent attention to detail and accuracy.
- Ability to prioritise workload and meet deadlines.
- Good communication skills for liaising with clinical and administrative staff.
- Proficient in IT systems and data entry.
Desirable
- Experience with CQRS, QOF, and NHS claims processes.
- Previous experience in a healthcare or primary care setting.
Person Specification
Qualifications
Essential
- GCSE grade A to C in English and Maths (minimum).
- Strong organisational and administrative skills.
- Excellent attention to detail and accuracy.
- Ability to prioritise workload and meet deadlines.
- Good communication skills for liaising with clinical and administrative staff.
- Proficient in IT systems and data entry.
Desirable
- Experience with CQRS, QOF, and NHS claims processes.
- Previous experience in a healthcare or primary care setting.
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.
