HEDIS Coordinator

JOB SUMMARY:

The Hedis Coordinator is the primary person to analyze patient chart data to confirm HEDIS measures are being met and addressed appropriately by the Physicians. This person will work closely and communicate with Insurance groups, Physicians and Medical Staff. The main objectives is to make sure that HEDIS GAPS are being addressed and communicating with the Physicians, Medical Staff and Senior Management on the status and issues met in their audits.

JOB DUTIES:

• Creating or modifying HEDIS ENCOUNTERS in patients’ charts to communicate with Physicians and Medical Staff.
• Assists with all quality measures initiatives, working with clinical offices in capturing the data to support the variables.
• Meeting with providers and clinical staff monthly to review scores and gap list
• Reviewing or creating various reports using Microsoft Excel. Ability to manipulate spreadsheets using features: filtering, sorting, grouping,
• Assisting with outside chart audits and submitting or required information as needed.
• Submitting/reporting patient information to various health plans via their portals as directed.
• Perform other duties as may be required.

JOB REQUIREMENTS

Education and/or Experience

• High School Diploma or GED is required
• One year of experience in medical office required
• Familiars with Medicare Advantage plans and HMO’s preferred

Required Knowledge, Skills and Abilities

• Critical Thinking / Problem solving
• Ability to use Microsoft Office, with a focus on Excel (or Libre Calc)
• Ability to collect and accurately relay pertinent information
• Ability to navigate computers, internet programs, and EMR systems
• Accurate, efficient data entry
• Ability to read/understand medical terminology
• Ability to read, understand, and analyze medical records
• Ability to read and understand technical specifications on all quality initiatives
• Ability to multitask and prioritize assignments based on urgency
• Ability to work independently with little to no need for assistance

Duties and Responsibilities include, but are not limited to:

• Assists with all quality measures initiatives, working with clinical offices in capturing the data to support the variables.
• Works all gap reports for 5 STAR and ACO quality measures projects as they become relevant and assists with all quality initiatives as assigned.
• Assists with patient events as needed.
• Accurately enters all identified and validated measures into the practice’s software program(s).
• Timely and accurately reports issues to management, as necessary.
• Meets daily and overall productivity and compliance expectations.
• Other duties as assigned.

· Education and Experience:

· Diploma or GED.

· One to two years’ previous healthcare experience preferred, but not required. This includes, but is not limited to, medical office, medical records, or healthcare quality.

· Knowledge of Microsoft Office programs is required. Must be able to demonstrate abilities in data entry, Excel, and Word via testing at interview.

· Language Ability:

· Ability to read and comprehend medical terminology, instructions, technical specifications, manuals, correspondence, and memos.

· Ability to write simple correspondence.

· Computer Skills:

· To perform this job successfully, an individual must have knowledge of Microsoft Office programs and have an ability to navigate computers, internet programs, and EMR systems.

Schedule:

• Monday thru Friday

Benefits Offered:

· Paid time off

· Health Insurance

· Dental insurance

· Vision insurance

Drug test, background check, is required for this position.

Job Type: Full-time

Benefits:

• 401(k)
• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Experience:

• HEDIS: 1 year (Preferred)
• Health Informatics Occupations: 1 year (Preferred)

License/Certification:

• Epic Certification (Preferred)

Work Location: One location