HEDIS Retrieval Coordinator

Duties

Under the direction of the Medical Record Review Ops Manager the HEDIS Retrieval Coordinator is responsible for:

Will participate in and provide guidance and support for the development and maintenance of the HEDIS Medical Record Review platform(s) to support all plans.

Review Roadmap for accuracy General Information Appendix 1 and Section 4

Coordinate the ongoing Medical Record collection and archiving of documents that support the Medical Record Review Projects regulatory audits and accreditation standards.

Pull incoming medical records from the fax and copy queues and save to the appropriate plan drive in the designated measurement folders.

Work on designated projects assigned and deemed as necessary.

Review and remediate pended chases by researching claims data web searches for correct provider demographics

Make outgoing calls to validate provider contact information

Document findings accurately in HEDIS project tool

Skills:

Experience with HEDIS measures and retrieval tactics

13 years Demonstrated expertise in project coordination office management medical record collection medical terminology call center creating and managing central data repositories and data management systems for an office or large department.

Proficient computer and typing skills required

Knowledge of medical terminology and basic charting

Microsoft Publisher Visio Excel power point Share Point and other web base applications

Able to think and work effectively under pressure.

The ability to function effectively within multidisciplinary teams.

Ability to accurately complete tasks within established times.

Ability to effectively prioritize multiple tasks and deadlines.

Education

HS Diploma or GED; Bachelorss Degree Preferred; Medical Terminology Preferred

Required Skills

TYPING

EXCEL

SHARE POINT

DATA MANAGEMENT

Additional

COLLECTION

OFFICE MANAGEMENT

VISIO

PUBLISHER

CHARTING

AUDIT

CLAIMS

QUEUE MANAGEMENT

MEDICAL RECORDS

ARCHIVING

MAINTENANCE

OFFICE MEDICAL