HCSC Clerk/Admin

W3R Consulting; Illinois; On-site; USD 52,000 - 64,000; Full time

Job summary

W3R Consulting in Illinois seeks a Records Data Specialist to support the HEDIS EDIS project. You will obtain medical record data, scan documents, and route them to the correct measures while maintaining confidentiality.

Under supervision of the HEDIS Coordinator, you will perform data entry, coordinate with QI Specialists, and ensure HIPAA compliance. Strong communication and data-entry skills are essential for success.

Qualifications

• 7+ years experience in a related role.
• High School Diploma or GED; Medical Assistant preferred.
• Customer service skills required.
• Data entry and/or typing experience.
• Proficient in Word, Excel and Lotus Notes.
• Strong written and verbal communication.
• Knowledge of medical terminology is helpful.

Responsibilities

• Obtain medical record data from PO Box and distribute to scanning for processing.
• Scan all paper documents; identify member and place in appropriate measure file.
• Enter data or update chase status using various software applications for HEDIS operations.
• Meet with HEDIS Coordinator/QI Specialists to discuss efforts and open issues.
• Notify staff of incoming medical record data requests and status.
• Follow up with provider offices as needed for record requests.
• Route complex issues to Quality Improvement Specialists/HEDIS Coordinator.
• Maintain HIPAA compliance and patient confidentiality.

Skills

Customer service

Data entry

Typing

Written and verbal communication

Medical terminology knowledge

Education

High School Diploma or GED

Medical Assistant preferred

Tools

Word

Excel

Lotus Notes

Job description

DESCRIPTION:

Staff will work under the supervision of the HEDIS Coordinator. They are a member of the medical record review team. The team is responsible for obtaining and performing accurate comprehensive reviews of medical records in support of The HEDIS Effectiveness Data and Information Set project. HEDIS reviews are completed in accordance with NCQA guidelines and technical specifications.

JOB REQUIREMENTS:

• 7+ years experience
• High School Diploma or GED. Medical Assistant preferred.
• Customer service skills
• Data entry and/or typing experience.
• PC proficiency to include Word, Excel and Lotus Notes.
• Clear and concise written and verbal communication skills.
• Knowledge of medical terminology is helpful

Duties and Responsibilities:

• Obtain medical record data from PO Box and distribute to for scanning purposes.
• Scan in all paper documents obtained from the mail or fax. Identify member to the appropriate measure. Label documents as directed and place in appropriate measure file.
• Utilizes various software applications to support HEDIS operations by entering data or changing chase status pertaining to the medical records.
• Meets with HEDIS Coordinator and / or QI Specialists to discuss HEDIS efforts, any open issues and can include IRR results.
• Advise the appropriate staff person of their request incoming medical record data.
• May be directed to calls a provider office to follow-up on requested for medical records.
• Routes all complex issues to the Quality Improvement Specialists/HEDIS Coordinator.
• Maintains compliance with HIPAA and patient confidentiality requirements.
• All other duties as assigned.