HEDIS Records Specialist

VIVA USA Inc; Chicago (IL); On-site; USD 55,000 - 70,000; Full time

Job summary

VIVA USA Inc. seeks staff to assist the HEDIS team with comprehensive medical record reviews in support of NCQA guidelines. You will obtain data, scan documents, and route information to the appropriate measures while ensuring accuracy and confidentiality.

You will use multiple software applications to enter data, track status, and coordinate with the HEDIS Coordinator and QI Specialists. Strong attention to detail and excellent communication are required.

Qualifications

• 7+ years experience in a related role.
• High School Diploma or GED; Medical Assistant preferred.
• Customer service skills and data entry proficiency.
• Strong written and verbal communication abilities.
• Knowledge of medical terminology is helpful.

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.

Skills

Customer service

Data entry

Typing

Written and verbal communication

Medical terminology

PC proficiency

Word

Excel

Lotus Notes

Education

High School Diploma or GED

Tools

Word

Excel

Lotus Notes

Job description

VIVA USA Inc. seeks staff to assist the HEDIS team with comprehensive medical record reviews in support of NCQA guidelines. You will obtain data, scan documents, and route information to the appropriate measures while ensuring accuracy and confidentiality.

You will use multiple software applications to enter data, track status, and coordinate with the HEDIS Coordinator and QI Specialists. Strong attention to detail and excellent communication are required.