Salary Range: $34.00 - $35.00 per hour
Posted on
Requirements:
Active Nursing License with two (2) years of related work experience
Must have previous medical record / quality review experience; HEDIS/STARS preferred
Must be proficient in Microsoft Office (Word, Excel, Outlook, and PowerPoint) as well as Internet research skills
Ability to communicate clearly verbally and in writing
Organizational skills are very important; must be able to work independently to complete tasks with minimal direction.
Preferred:
Disease management experience is helpful
Recent experience in medical record reviews, data collection for HEDIS / Stars
Job Description:
Perform medical record reviews to support improvement and compliance, abstract HEDIS data, to include over-read of reviews, working collaboratively with internal HEDIS STARs Team and the Quality Team.
Perform administrative functions to include; medical record request, faxing and calls to members and providers as needed. Maintain organized, updated reporting of activities with clear documentation. Required to track, monitor and report on the status of records and volume of work.
Complete claim research to identify the service performed, dates of service, provider type, and place of service. Research may include multiple systems and reports.
Established in 1995, w3r Consulting is an award-winning national leader, providing data management and analytics, technology consulting services, and talent solutions. We partner with a diverse range of businesses and organizations, including Fortune 500 companies spanning the automotive, financial, government, health care, insurance, and retail industries.