Job Description

Job Description

Job Description

We are offering a short-term contract employment opportunity for a Medical HEDIS Coordinator in Arcadia, California. As part of our team, you will be assisting in the deployment and implementation of medical retrieval strategies, working closely with educators to schedule appointments for retrievals, and conducting continuous training and education on HEDIS measures.

Responsibilities:
• Assist with the deployment and implementation of medical retrieval strategies.
• Collaborate with educators to schedule appointments for retrievals.
• Conduct continuous training and education on HEDIS measures.
• Collect member records and conduct reviews by contacting providers.
• Input the results collected into a specific database.
• Facilitate fax or telephone call notification for providers utilizing reports.
• Create training materials, including PowerPoint decks, for providers and staff.
• Compile the required documentation to maintain critical quality improvement functions.
• Conduct telephonic and electronic outreach to patients.
• Perform HIPAA compliant outreaches to patients for medication adherence/utilization and other risk/quality gaps closure support.
• Identify barriers that prevent patients from closing any gaps and work with care team members to help patients manage their health.
• Coordinate with members of the patient care team, including vendors, providers, pharmacists, nurses, and patient care coordinators to address patient needs.• Minimum of 2 years of experience in a similar role as a Medical HEDIS Coordinator.
• Proficiency in using Allscripts and Cerner Technologies is essential.
• Ability to efficiently operate various Computer Programs.
• Experience in using CRM software for managing customer relationships.
• Working knowledge of EHR SYSTEM is a must.
• Capable of answering inbound calls professionally and promptly.
• Experience in managing authorizations in a healthcare setting.
• Familiarity with benefit functions in the healthcare industry.
• Understanding of billing functions and procedures in a medical environment.
• Proven experience in providing quality customer service in a call center setting.
• Proficiency in the Korean language is a plus.

Job Tags

Fixed term contract,

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