Description We are currently hiring for seasonal HEDIS support with a large Fortune 500 Healthcare company in the Helena MT and surrounding area! This position will be primarily work from home!Job Overview:
We are committed to improving health outcomes and enhancing the quality of care for our members. As a leader in the healthcare industry, we prioritize innovation, teamwork, and a patient-centered approach.
In this role you will assist in the collection, validation, and reporting of HEDIS measures during the seasonal review period. This role is essential for ensuring compliance with national quality standards and enhancing the overall performance of our healthcare services.
Key Responsibilities:
Collaborate with cross-functional teams to gather and analyze data related to HEDIS measures.
Conducts claims research, determining correct service location and/or verifying member history
Performs provider outreach, verifying and confirming provider demographics & medical record requests, both by telephone and in writing
Requests medical records and performs follow up of requests within database tools
Performs medical record reviews for risk adjustment, HEDIS® and HEDIS®-like measures via remote EMR access or onsite
Support the data collection process, ensuring accuracy and timeliness.
Communicate effectively with team members and leadership regarding progress and challenges,
Maintains HIPAA standards and confidentiality of protected health information; reports critical incidents immediately
Requirements
Required Qualifications:
Must have a high school diploma or equivalent
Designated workplace at home free of distractions
Reliable, highspeed internet connection
Ability to contact providers and request data independently, by telephone and in writing
Minimum 1 year healthcare/health plan experience
Experience in claims/medical record review/medical billing/medical office
Experience and confidence with placing outbound phone calls
Proficient in Microsoft Office applications including Excel, Outlook, Word
Requires use of personal vehicle if onsite travel is needed (valid driver’s license required)
Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more.All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.© 2024 Robert Half. An Equal Opportunity Employer. M/F/Disability/Veterans. By clicking “Apply Now,” you’re agreeing to Robert Half’s Terms of Use (https://www.roberthalf.com/us/en/terms) .
Full-time