HEDIS Coordinator

Title: HEDIS Coordinator
Location: Remote 
Duration: 4 Months

Position Purpose – This role is to utilize claims research tools and provider outreach to resolve barriers to successful chart retrieval (pends).
Work volumes will fluctuate as we receive Pended requests so there may not be a full 40 hour week every week. As pends are received daily, assignments in groups of an average of 50 requests will be sent out. Communication of work is sent largely through Teams messaging and outlook. Review findings will be entered into a shared database.
Pend HEDIS Coordinators are expected to complete a review of 40 pends daily.
The need for critical thinking to review, assess and research measures associated with the claims.

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

Candidate Requirements
Education/Certification				Preferred:
Licensure				Preferred:
High School Diploma with 2+ years medical office, medical billing, or insurance claims experience Education Preferred: Medical Billing, Medical Coding, or Insurance Claims
Top 3 must-have hard skills stack-ranked by importance		1	Attention to detail
		2	Healthcare experience in medical terminology, medical record review, coding, or similar experience
		3	Ability to be productive independently

 
 
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws.This position's pay range is $18.00/hr - $20.00/hr.