Job Description
Job Responsibilities:
- Supports effective medical record capture for HEDIS medical record review and abstraction of supplemental data.
- Performs provider/location research, clean up, and data updates to ensure that medical record requests are submitted to the right location and PHI is properly handled
- Conducts HEDIS provider chart request calls, faxes, and mailings.
- Identifies potential resources and initiates collaboration with providers to improve member health outcomes and HEDIS measure rates
- Facilitates provider and member outreach to ensure member receipt of important clinical services to improve member health outcomes and close gaps in care.
- Identifies when to refer member to Social Worker or Case Manager.
- Assists in the development and standardization of outreach documentation and manages the data flow process to complete HEDIS documentation.
- Documents member participation in outreach activities in accordance with abstraction and audit standards.
- Records and documents all members and provide outreach activity.
Skills:
- Minimum 1 year, recent HEDIS project support-related experience
- Strong communication skills and experience speaking with medical providers.
- Ability to use standard corporate software packages and corporate applications.
- Computer skills: Microsoft Word, Excel, Outlook, Teams, Adobe Reader, RightFax
- Recent and related experience working in health care marketing, member outreach and/or health education experience.
- Experience working in call center environment
Education/Experience:
- Associate degree or equivalent experience
Job Tags
Remote job, Work at office,