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Medical Records Clerk / HEDIS Specialist

Company: N/A

Location: Columbus, OH

Pay: N/A

Contact Information


Name: Trixie Gular
Phone: 973-889-5291
Fax: n/a
Apply Online

Job Description





Looking for Medical Records Clerk / HEDIS Specialist






Under the direction of the HEDIS
Program Manager, supports the annual HEDIS project management by coordinating
the identification, collection and abstraction of medical records and other
data in collaboration with other HEDIS staff


Essential Functions:


• Assists the Manager
in the coordination and preparation of the HEDIS medical record review which
includes ongoing review of records submitted by providers and the annual HEDIS
medical record review.


• Participates in meetings
with vendors for the medical record collection process. Assists Manager with
medical record vendor oversight.


• Assists Manager in
training abstractor staff and participates in the medical record IRR.


• Identifies member
service gaps based on data loaded in the MHI HEDIS application.


• Collects medical
records and reports from provider offices based on member needed services
reports and gaps and loads data into the HEDIS application.


• Works with the corporate
HEDIS team to monitor accuracy of abstracted records as required by HEDIS
specifications.


• Participates in
scheduled meetings with the corporate HEDIS team, vendors and HEDIS auditors.


• Assists the QI
staff with physician and member interventions and incentive efforts as needed.


• Provides data
collection and report development support for Quality Improvement studies and
performance improvement projects.


• Assists as needed
in support of accreditation activities such as NCQA reviews, CAHPS and state
audits.






 


Job Requirements




Knowledge/Skills/Abilities:


• Proficient with
PC-based systems and the ability to learn new information systems and software
programs


• Ability to work
with large files and data sets


• Basic understanding
of Health Plan billing practices and information systems


• Strong
communication and teaming/interpersonal skills; strong leadership capabilities


• Ability to initiate
and maintain cross-team relationships


• Excellent verbal
and written communication skills


• Maintain regular
attendance based on agreed-upon schedule


• Maintain
confidentiality and comply with Health Insurance Portability and Accountability
Act (HIPAA)


• Ability to
establish and maintain positive and effective work relationships with
coworkers, clients, members, providers and customers





Required Education: State Licensed Vocational Nurse or
Registered Health Information Technician (RHIT), or Certified Medical Record
Technician with training in coding procedures.



Required Experience:


0-2 years coding and
medical record abstraction experience.


0-2 years managed
care experience.


Basic knowledge of
HEDIS and NCQA.



Required
Licensure/Certification:


Licensed LVN/LPN,
Registered Health Information Technician (RHIT), or Certified Medical Record
Technicians







If you have any
concern regarding this job opportunity please feel free to reach me at
973-889-5291 or you can email me at [Click Here to Email Your Resumé]