Job description

Duties:

· Under the direction of the Lead HEDIS Reviewer the HEDIS Coordinator is responsible for:

o 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.

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

o Work collaboratively with the Manager, HEDIS to maintain the Department SharePoint site, drives, medical records, blogs, newsletters and other program materials as deemed necessary.

o Participate in and provide support for process improvement initiatives with the medical record review process across the enterprise.

o Maintain provider outreach to support HEDIS and MRR projects to include but not limited to: Validation of fax numbers, provider office locations, HEDIS contact information, scheduling of onsite retrieval appointments; maintenance and follow-up for pull lists and investigation into further needed documentation.

o File copy company invoices, print pull list from MRR tool and save to plan drive.

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

o Scan all incoming medical records received via from mail or onsite visit to the appropriate plan drive in the designated measurement folders.

o Performs and applies structured auditing abstraction criteria to medical records to determine compliance to NCQA HEDIS specification and data collection activities as designated by the health plan for the measures such as CIS, IMA, CBP, CCS or other measures as deemed necessary.

o Maintain an abstraction proficiency rate of 98% by correctly reading, interpreting, and abstracting various components of the medical record such as notes, consultations, medication forms, treatment plans, health history, interval history, and past history.

o Work on designated projects assigned and deemed as necessary.

o Ability to analyze data including statistical analyses. Ability to analyze practices, identify trends and make recommendations for improvement of practice and processes related to Medical Record Retrieval and HEDIS. Recommends and implements program improvements that strengthen the MRR process and be able to present in a written report.

o Review Roadmap for accuracy General Information, Appendix 1, and Section 4

Skills:

· 1-3 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.

· Knowledge of medical terminology and basic charting

· Microsoft Publisher, Visio, Excel, power point, Share Point.

• 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:

High School/GED

Job Type: Contract

Salary: $20.00 - $27.00 per hour

Benefits:

• Dental insurance
• Health insurance
• Vision insurance

Schedule:

• Day shift

Ability to commute/relocate:

• Newtown Square, PA 19073: Reliably commute or planning to relocate before starting work (Required)

Experience:

• HEDIS: 1 year (Preferred)
• Medical Record Review: 1 year (Preferred)
• Medical records: 1 year (Preferred)

License/Certification:

• Epic Certification (Preferred)

Work Location: One location

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