HEDIS Coordinator

Spectraforce Technologies

United States, Kentucky, Louisville

Dec 11, 2024

Title: HEDIS Coordinator

Duration: 04 Months (Potential to extend)

Location: Remote

Position Purpose - The pend HEDIS coordinator is responsible for utilizing claims research tools and provider outreach to resolve barriers to successful chart retrieval (pends), supporting Quality Improvement initiatives within the organization.

Technology Requirements - This position requires the use of a personal at home wired cable, fiber, DSL, or BPL internet connection. Dial-up, Satellite, Wi-Fi only, and Wireless do not meet the security requirements, or the downstream and upstream speeds required for the programs being utilized.

Day to Day Responsibilities of this Position:

Attend trainings and meetings and complete testing in the required timeframe with a satisfactory pass rate.
Resolve outstanding vendor and in-house pends within a timely manner using claim systems and research.
Maintain daily averaged expected productivity output.
Communicate and collaborate with Project Managers, and coworkers.
Follow HIPAA guidelines and company guidelines to safeguard PHI and PII.
Utilize company-supplied equipment in a private, secured, at-home location using wired cable, fiber, DSL, or BPL internet.
Good customer service skills for provider outreach.
Additional tasks as delegated by Project Manager or Manager.

Internal/External Groups with which the Candidate will interface:	Client's Corporate HEDIS Pursuit Operations
Required Skills/Experience:		Preferred Skills/ Experience:
1.	Attention to detail	1.	HEDIS Project experience
2.	Ability to be productive independently	2.	Claims system research experience
3.	Healthcare experience in medical terminology, medical record review, coding, or similar experience	3.	Copy service vendor experience
4.	Familiarity with basic computer use and navigation	4.	Ability to adapt to changing priorities in managing a wide range of projects.
Education Requirement:	High School Diploma with 2+ years medical office, medical billing, or insurance claims experience	Education Preferred:	Medical Billing, Medical Coding, or Insurance Claims
Software Skills Required:	Microsoft Suite - Word, Outlook, and Excel, beginner to intermediate
Required Certifications:	No	Required Testing:	No