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Medical Records Clerk / HEDIS Specialist in Columbus, OH at Collabera

Date Posted: 11/7/2018

Job Snapshot

Job Description

Looking for Medical Records Clerk / HEDIS Specialist

Under the direction of the HEDISProgram Manager, supports the annual HEDIS project management by coordinatingthe identification, collection and abstraction of medical records and otherdata in collaboration with other HEDIS staff

Essential Functions:

• Assists the Managerin the coordination and preparation of the HEDIS medical record review whichincludes ongoing review of records submitted by providers and the annual HEDISmedical record review.

• Participates in meetingswith vendors for the medical record collection process. Assists Manager withmedical record vendor oversight.

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

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

• Collects medicalrecords and reports from provider offices based on member needed servicesreports and gaps and loads data into the HEDIS application.

• Works with the corporateHEDIS team to monitor accuracy of abstracted records as required by HEDISspecifications.

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

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

• Provides datacollection and report development support for Quality Improvement studies andperformance improvement projects.

• Assists as neededin support of accreditation activities such as NCQA reviews, CAHPS and stateaudits.

Job Requirements


• Proficient withPC-based systems and the ability to learn new information systems and softwareprograms

• Ability to workwith large files and data sets

• Basic understandingof Health Plan billing practices and information systems

• Strongcommunication and teaming/interpersonal skills; strong leadership capabilities

• Ability to initiateand maintain cross-team relationships

• Excellent verbaland written communication skills

• Maintain regularattendance based on agreed-upon schedule

• Maintainconfidentiality and comply with Health Insurance Portability and AccountabilityAct (HIPAA)

• Ability toestablish and maintain positive and effective work relationships withcoworkers, clients, members, providers and customers

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

Required Experience:

0-2 years coding andmedical record abstraction experience.

0-2 years managedcare experience.

Basic knowledge ofHEDIS and NCQA.


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

If you have anyconcern regarding this job opportunity please feel free to reach me at973-889-5291 or you can email me at