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HEDIS specialist in Houston, TX at DISYS

Date Posted: 12/1/2018

Job Snapshot

  • Employee Type:
    Contractor
  • Location:
    Houston, TX
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:
    12/1/2018

Job Description

TITLE                        -  HEDIS Specialist

LOCATION               -  Texas/New Mexico

CONTRACT              -  3+ months

Job Description:

Essential Functions:

•        Assists the Manager in the coordination and preparation of the HEDIS medical record review which includes ongoing review of records submitted by providers and the annual HEDIS medical record review.

•        Participates in meetings with vendors for the medical record collection process.

•        Assists Manager with medical record vendor oversight.

•        Assists Manager in training abstractor staff and participates in the medical record IRR.

•        Identifies member service gaps based on data loaded in the MHI HEDIS application.

•        Collects medical records and reports from provider offices based on member needed services reports and gaps and loads data into the HEDIS application.

•        Works with the corporate HEDIS team to monitor accuracy of abstracted records as required by HEDIS specifications.

•        Participates in scheduled meetings with the corporate HEDIS team, vendors and HEDIS auditors.

•        Assists the QI staff with physician and member interventions and incentive efforts as needed.

•        Provides data collection and report development support for Quality Improvement studies and performance improvement projects.

•        Assists as needed in support of accreditation activities such as NCQA reviews, CAHPS and state audits.

Knowledge/Skills/Abilities:

•        Proficient with PC-based systems and the ability to learn new information systems and software programs

•        Ability to work with large files and data sets

•        Basic understanding of Health Plan billing practices and information systems

•        Strong communication and teaming/interpersonal skills; strong leadership capabilities

•        Ability to initiate and maintain cross-team relationships

•        Excellent verbal and written communication skills

•        Ability to abide by client’s policies

•        Maintain regular attendance based on agreed-upon schedule

•        Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)

•        Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers

Required Education:

•        State Licensed Vocational Nurse or Registered Health Information Technician (RHIT), or Certified Medical Record Technician with training in coding procedures.

Required Experience:

•        0-2 years coding and medical record abstraction experience.

•        0-2 years managed care experience.

•        Basic knowledge of HEDIS and NCQA.

Required Licensure/Certification:

•        Licensed LVN/LPN, Registered Health Information Technician (RHIT), or Certified Medical Record Technicians

Job Requirements

TITLE                        -  HEDIS Specialist

LOCATION               -  Texas/ New Mexico

CONTRACT              -  3+ months

Job Description:

Essential Functions:

•        Assists the Manager in the coordination and preparation of the HEDIS medical record review which includes ongoing review of records submitted by providers and the annual HEDIS medical record review.

•        Participates in meetings with vendors for the medical record collection process.

•        Assists Manager with medical record vendor oversight.

•        Assists Manager in training abstractor staff and participates in the medical record IRR.

•        Identifies member service gaps based on data loaded in the MHI HEDIS application.

•        Collects medical records and reports from provider offices based on member needed services reports and gaps and loads data into the HEDIS application.

•        Works with the corporate HEDIS team to monitor accuracy of abstracted records as required by HEDIS specifications.

•        Participates in scheduled meetings with the corporate HEDIS team, vendors and HEDIS auditors.

•        Assists the QI staff with physician and member interventions and incentive efforts as needed.

•        Provides data collection and report development support for Quality Improvement studies and performance improvement projects.

•        Assists as needed in support of accreditation activities such as NCQA reviews, CAHPS and state audits.

Knowledge/Skills/Abilities:

•        Proficient with PC-based systems and the ability to learn new information systems and software programs

•        Ability to work with large files and data sets

•        Basic understanding of Health Plan billing practices and information systems

•        Strong communication and teaming/interpersonal skills; strong leadership capabilities

•        Ability to initiate and maintain cross-team relationships

•        Excellent verbal and written communication skills

•        Ability to abide by client’s policies

•        Maintain regular attendance based on agreed-upon schedule

•        Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA)

•        Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers and customers

Required Education:

•        State Licensed Vocational Nurse or Registered Health Information Technician (RHIT), or Certified Medical Record Technician with training in coding procedures.

Required Experience:

•        0-2 years coding and medical record abstraction experience.

•        0-2 years managed care experience.

•        Basic knowledge of HEDIS and NCQA.

Required Licensure/Certification:

•        Licensed LVN/LPN, Registered Health Information Technician (RHIT), or Certified Medical Record Technicians

Digital Intelligence Systems, LLC. is an Equal Opportunity Employer, M/F/D/V. We do not discriminate against any employee or applicant because they inquired about, discussed, or disclosed compensation. Email recruitinghelp @ disys.com to contact us if you are an individual with a disability and require accommodation in the application process.