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

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