Medical Assistant for HEDIS Quality

3 months ago

Watkinsville, United States CAAP Full time
Job DescriptionJob Description

HEDIS Quality Specialist

Job Description

 

 

Position Summary:

The HEDIS Quality Specialist will take an active role in chart review and capturing data not captured by payors by mining patient charts for quality HEDIS gaps and recording findings with the CIN Clinical Database. The Quality Specialist will assist the clinical care team to identify deficits at the time of patient’s appointments and gather clinical data at the time of office visits as well as assure proper data is in the patient’s medical chart. The Quality Specialist will also be responsible for assisting patients with scheduling their preventative screenings.

 


Essential Functions:

 

  • Perform chart audits to abstract records as needed and to determine true open gaps in office or via remote EMR.

  • Contact patients to schedule preventative screenings when applicable.

  • Facilitate Diabetic Eye Exam Days & Mobile Mammography Days were applicable.

  • Coordinate distribution of at home testing kits.

 

 

QUALIFICATIONS:

 

  • High school graduate. Some college or technical education preferred in the Allied Health professional field of study.

  • Healthcare related experience preferred.

  • Strong organizational and time management skills, able to work with little supervision while handling numerous projects at once.

  • Excellent written/verbal communication skills, especially the ability to communicate telephonically in a professional and effective manner.

  • Computer literacy in all Microsoft Office products.

  • Requires flexibility, to be able to switch priorities in positive and effective manner when directed by leadership.

  • Positive, service-oriented attitude.

  • High level of integrity.

  • Requires frequent local travel to provider offices. Must maintain valid Georgia driver’s license and vehicle.

  • Willingness and ability to attend after hour business meetings as needed.

  • Ability to obtain and utilize sensitive information discreetly and objectively.

 

JOB DUTIES:

 

  • Build relationships with designated providers and their staff in a way that promotes mutual respect and trust.

  • Maintains effective communication via phone, email, and in-person meetings.

  • Collaborates with management and other departments to identify opportunities for education and process improvement.

  • Assure that all provider site visit and engagement assessments are completed within designated timeframes.

  • Travel to and interact with the physician’s office to access and review the patient clinical information.

  • Recognize deficits in patient charts and work with clinical staff to contact patients and organize solutions to meet the deficiency.

  • Collect data from physician EMR systems and reconcile it with data from the payors.

  • Daily patient outreach to schedule preventative screenings when applicable.

 

 

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