JOB DESCRIPTION Job Summary Provides lead level support for medical records collection activities. Responsible for quality improvement activities including outreach to providers for collection of medical records for Healthcare Effectiveness Data and Information Set (HEDIS) specific data collection, projects and audit processes. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job Duties Outreaches to providers via phone call, fax, mail, electronic medical record system (EMR) retrieval, and direct on-site pick up for collection of medical records. Loads medical records and reports from provider offices into the Healthcare Effectiveness Data and Information Set (HEDIS) application. Provides subject matter expertise in project management/coordination of identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff. Supports annual HEDIS audit and other like audits, and organizes provider outreach, pursuit, collection and upload of provider medical records into the internal database. Subject matter expert in the area of collecting medical records and reports from provider offices, loads data into the HEDIS application. Assists the medical records leadership and quality improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation. Provides mentorship and leadership to team members and represents as lead on process and project improvement initiatives. Participates in and prepares feedback for meetings with vendors related to the medical record collection process. Some medical records collection related travel may be required.
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Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
Number of Employees
5,001-10,000 employees