Medical Record Specialist - HEDIS

Location: Wallingford, CT
Date Posted: 11-01-2018
CONTRACT Medical Record Specialist - HEDIS®
*** Full Time, Benefits Available, CONTRACT opportunity, expected to last through May or June of 2019! ***
Your Job Summary:
The primary responsibility of the HEDIS Medical Record Specialist is to provide administrative, clerical, and scheduling support to HEDIS Abstractors conducting the Chart Review and Chart Abstraction portion of the HEDIS (Healthcare Effectiveness Data and Information Set) Audit.  The Specialist is responsible for providing basic administrative and telephonic support for the Quality Improvement department in order to meet deadlines associated within the project. The Specialist will work under the direction of the Team Lead to assist with requests for information by contacting provider practices. They will coordinate with provider offices to verify information, transfer documents, schedule onsite visits if needed, and other administrative functions.  A high degree of telephonic and in-person professionalism and team effort is expected to be maintained throughout the duration of the project.
Your Reward:
Excellent Seasonal Position with Highly Competitive Salary and Full Benefits available!
Your Background:
High School diploma or equivalent; Associate’s Degree preferred.
At least 1-3 years experience managing medical records in an administrative / support capacity.
Prior experience with HEDIS projects or other healthcare quality initiatives is highly desirable.
Familiarity with medical terminology, customer service, or a call center background are also preferred
Strong computer literacy (MS Excel) and typing skills (30-40 WPM) are necessary.
Must have basic grasp of medical terminology and clinical reports or documentation.
Should poses basic business acumen, such as knowledge of the relationships between network providers, beneficiaries, and managed care organizations.
Strong oral and written communication skills; ability to interact within all levels of the organization as well as with external contacts. 
Must be able to write clearly, concisely, and professionally about medical cases.
Must be able to prioritize, plan, and handle multiple tasks/demands simultaneously.
Must be willing and able to travel to area provider offices and facilities, if needed.
Your Duties:
Manage Medical Records
  • medical privacy and confidentiality is maintained at all times
  • records are stored in locked filing cabinets
  • records are retrieved only as requested by staff and auditors
  • research within the company’s claim systems to assist abstractors to identify provider location
  • call members as directed to inquire about the provider of their care
  • a high degree of professionalism in telephonic dialog must be maintained
Process Documentation
  • maintain office equipment such as fax, camera, scanner, computer
  • retrieve previously scanned or filed information
  • place telephone calls to provider offices
  • oversee incoming and outgoing fax documents
  • monitor faxed requests for records and replies
  • copy, verify label, sort, prepare batches
  • file, type, collate, distribute documents
  • assemble and scan and/or upload documents 
Support Scheduling
  • communicate with provider offices efficiently and accurately
  • book appointments for HEDIS Audit Staff
  • verify information, such as hours and address
  • schedule HEDIS office reviews
  • confirm next day appointments
  • verify addresses for fax and mail
  • maintain tracking log and calendar 

® “HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA).”
623.201.8732 (CALL – TEXT – FAX)
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