HEDIS Coordinator (TEMP)
Location: Orange, California US
Job Number: 1410
Position Title: HEDIS Coordinator
The temporary HEDIS Coordinator is responsible for supporting HEDIS data collection and chart retrieval for the annual NCQA health plan audit. This individual will perform medical record collection, reviews, and abstract data to support compliance with HEDIS measure sets.
General Duties Responsibilities
(May include but are not limited to)
- Retrieve medical record supporting documentation, which may include outbound calls to provider offices, scanning charts, and downloading files from EMR or other health plan systems.
- Assist vendor performing chart collection for AHC with any issues (“pends”) by performing additional research or outreaching to provider offices to address any issues.
- Review, locate, and abstract measure-specific clinical data from medical records for documentation supporting HEDIS gap closure.
- Ensure all abstracted data meets documentation guidelines by applying NCQA’s technical specifications.
- Follow standard departmental processes, policies, and procedures with regards to performing abstraction and coding activity.
- Ensure patient privacy is protected by adhering to HIPAA standards, company policies and procedures, and other federal, state, and local requirements.
- Assist with other HEDIS initiatives, as required by the department.
This position has no supervisory responsibilities.
- Minimum Experience:
- 1 year of healthcare industry experience required (health plan, managed care, medical group / IPA, or provider office preferred)
- Experience in HEDIS / STAR, or other quality area preferred.
- Experience in member services (health plan, managed care, or medical group / IPA) preferred.
- Education / Licensure:
- High school diploma or general education degree (GED) required
- Certified coder (CPC, CCS, CCS-P, CRC, COC, CPC-P, RHIT or RHIA Certification) preferred.
- Excellent customer service and phone skills.
- Proficient in Microsoft Excel.
- Knowledge of medical terminology and HIPAA.
- Strong attention to detail, problem-solving, and analytical skills are essential.
- Self-starter; able to work independently with minimal supervision.
- Strong communications skills: written, verbal, and interpersonal
Essential Physical Functions
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- The employee frequently lifts and / or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.
Location City: Orange
Location State: California
Community / Marketing Title: HEDIS Coordinator (TEMP)
Who is Alignment Healthcare?
- Socially responsible
- Technologically enabled
- Concierge care
- Servant leadership
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