HEDIS Specialist

Integrated Resources Inc.; Springfield (IL); On-site; USD 40,000 - 60,000; Full time

Job summary

A leading company in healthcare solutions is seeking a HEDIS Coordinator to support project management. The ideal candidate will have experience in managed care and HEDIS processes, responsible for collecting medical data and ensuring compliance. This role requires strong communication skills and familiarity with healthcare regulatory standards, offering a dynamic environment focused on efficiency and quality.

Qualifications

• 2-4 years Managed Care experience required.
• Experience in HEDIS medical record collection and abstraction.
• Basic knowledge of HEDIS and NCQA desired.

Responsibilities

• Coordinate identification, collection, and abstraction of medical records.
• Send and receive medical records via fax or mail.
• Make calls or drive to provider offices for records.

Skills

Verbal communication

Written communication

Multi-tasking

Education

Licensed LVN/LPN, RHIT, or RN for state of IL

Tools

PC-based systems

Job description

Integrated Resources, Inc., is led by a seasoned team with combined decades in the industry. We deliver strategic workforce solutions that help you manage your talent and business more efficiently and effectively. Since launching in 1996, IRI has attracted, assembled and retained key employees who are experts in their fields. This has helped us expand into new sectors and steadily grow.

We’ve stayed true to our focus of finding qualified and experienced professionals in our specialty areas. Our partner-employers know that they can rely on us to find the right match between their needs and the abilities of our top-tier candidates. By continually exceeding their expectations, we have built successful ongoing partnerships that help us stay true to our commitments of performance and integrity.

Our team works hard to deliver a tailored approach for each and every client, critical in matching the right employers with the right candidates. We forge partnerships that are meant for the long term and align skills and cultures. At IRI, we know that our success is directly tied to our clients’ success.

Job Description

Under the direction of the HEDIS Program Manager, supports the annual HEDIS project management by coordinating the identification, collection and abstraction of medical records and other data in collaboration with other HEDIS staff.

Responsibilities:

• Sending out fax requests for medical records.
• Receiving medical records via fax or mail, filing, scanning, and uploading medical records.
• Basic medical retrieval calling into offices or driving to provider offices to pick up records.

Knowledge/Skills/Abilities:

• Proficient with PC-based systems and the ability to learn new information systems and software programs.
• Excellent verbal and written communication skills.
• HEDIS experience, facilitation experience, provider outreach experience, ability to multi-task, owning and accountable for provider sites.
  

Qualifications

Required Experience:

• A minimum of 2-4 years of Managed Care experience within the Healthcare industry.
• 2-4 years of HEDIS medical record collection and abstraction.
• Basic knowledge of HEDIS and NCQA.

Licensed Required:

LVN/LPN, Registered Health Information Technician (RHIT), or Certified Medical Record Technicians or RN for state of IL

Additional Information

All your information will be kept confidential according to EEO guidelines.