POPULATION HEALTH COMPLIANCE TECHNICIAN

ADP, Inc.; Miami (FL); On-site; USD 24,000 - 33,000; Full time

Job summary

Automatic Data Processing, Inc. in Miami hires a Population Health Compliance Technician to perform medical record reviews for HEDIS measures, data abstraction, and coding quality under HIPAA.

The role requires a high school diploma or GED, completion of a Medical Coding or Medical Assisting program, CPR certification, knowledge of ICD-9/CPT, and bilingual English/Spanish preferred. This is an on-site, full-time hourly role.

Qualifications

• Graduate from a Standard High School or GED Equivalent
• Graduate from an approved Medical Coding Program, Medical Assisting program preferred
• Maintain current CPR certification from the American Heart Association
• MA certification or coding certification desired
• Knowledge of ICD9 and CPT Coding
• Bilingual in English/Spanish preferred

Responsibilities

• Performing accurate and comprehensive reviews of medical records for HEDIS measures
• Auditing high volumes of medical records to ensure correct and appropriate code assignment
• Ability to multitask and troubleshoot problems independently
• Ensuring accurate data entry for claim submission
• Medical record review, data abstraction, and quality experience
• Schedule appointments with health care provider including appointments to PCP for their health risk assessments, preventative visits and chronic care management
• Participate in Performance Improvement Activities
• Participate in appropriate continuing education in service training
• Maintain current licensure and/or certificates
• Ability to read and interpret medical documents
• Ability to prioritize, multi-task, and achieve goals on time; work independently and to self-motivate
• Strong data entry skills; capable of using a computer efficiently and effectively
• Able to navigate and master practice management and EHR software programs
• Treat clients, team members and the public with courtesy, respect and present a positive public image
• High production environment and, candidates must adhere to measured productivity requirements
• Ensuring adherence to NCQA HEDIS guidelines
• Research medical history to determine the most appropriate and source of necessary documentation
• Based on a strong knowledge of HEDIS criteria, identify the medical information that supports the specific HEDIS measure
• Responsible for obtaining, organizing, and securing a large volume of medical records within a limited timeframe
• Adhere to department Policies and Procedures in performing duties and assignments
• Demonstrates the ability to work with a diverse population
• Ability to post appropriate CPT Category II Performance Measure codes after chart review and audit
• Reports to work on time and ready to work with minimal absenteeism
• Adheres to Confidentiality Policies and Procedures / HIPAA Regulations
• Well organized with the ability to maintain attention to detail
• Ability to work independently and as a team member
• Maintains productivity standard of reviewing 60 medical records daily

Skills

Medical Terminology

Keyboard

Medicare/Medicaid knowledge

NCQA HEDIS requirements

ICD9 and CPT Coding

Basic computer knowledge

Bilingual English/Spanish

Education

High School Diploma or GED

Medical Coding Program

Medical Assisting program preferred

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

POPULATION HEALTH COMPLIANCE TECHNICIAN

990119 Population Health Program Active - Hourly full-time Technicians Miami, FL, US

2 days ago Requisition ID: 1941

Salary Range: $17.36 To $24.26 Hourly

POSITION PURPOSE:

Provides ongoing VBS/HEDIS medical record collection and abstraction; and supports the abstraction of medical records related to VBS/HEDIS Compliance initiatives. Provides accurate assessment of provider performance against VBS/HEDIS standards and procedures. Adheres to strict HIPAA confidentiality requirements for protected health information. Works under general supervision.

POSITION REQUIREMENTS / QUALIFICATIONS:

Education/Experience:

Graduate from a Standard High School or GED Equivalent. Graduate from an approved Medical Coding Program, Medical Assisting program preferred.

Licensure / Certification:

Maintain current CPR certification from the American Heart Association. MA certification or coding certification desired

Skills / Ability:

Medical Terminology, Keyboard, Knowledge of Medicare, Medicaid, and Managed Care coverage benefits/limitations, NCQA HEDIS requirements. Knowledge of ICD9 and CPT Coding. Basic computer knowledge is preferred. Bilingual in English/Spanish preferred.

POSITION RESPONSIBLITIES (THIS IS A NON-EXEMPT POSITION):

Performing accurate and comprehensive reviews of medical records for HEDIS measures.

Auditing high volumes of medical records to ensure correct and appropriate code assignment.

Ability to multitask and troubleshoot problems independently.

Ensuring accurate data entry for claim submission.

Medical record review, data abstraction, and quality experience.

Schedule appointments with health care provider including appointments to PCP for their health risk assessments, preventative visits and chronic care management.

Participate in Performance Improvement Activities.

Participate in appropriate continuing education in service training.

Maintain current licensure and/or certificates.

Ability to read and interpret medical documents.

Ability to prioritize, multi-task, and achieve goals on time; work independently and to self-motivate.

Strong data entry skills; capable of using a computer efficiently and effectively.

Able to navigate and master practice management and EHR software programs.

Treat clients, team members and the public with courtesy, respect and present a positive public image.

High production environment and, candidates must adhere to measured productivity requirements.

Ensuring adherence to NCQA HEDIS guidelines.

Research medical history to determine the most appropriate and source of necessary documentation.

Based on a strong knowledge of HEDIS criteria, identify the medical information that supports the specific HEDIS measure.

Responsible for obtaining, organizing, and securing a large volume of medical records within a limited timeframe.

Adhere to department Policies and Procedures in performing duties and assignments.

Demonstrates the ability to work with a diverse population.

Ability to post appropriate CPT Category II Performance Measure codes after chart review and audit.

Reports to work on time and ready to work with minimal absenteeism.

Adheres to Confidentiality Policies and Procedures / HIPAA Regulations.

Well organized with the ability to maintain attention to detail.

Ability to work independently and as a team member.

Maintains productivity standard of reviewing 60 medical records daily.