Lead Medical Records Collector

About This Role

This role provides lead-level support for medical records collection activities, focusing on quality improvement initiatives and HEDIS specific data collection, projects, and audit processes. The Lead contributes to the overall strategy for providing quality and cost-effective member care.

Responsibilities

• Outreach to providers via phone, fax, mail, EMR, and on-site pick up for medical record collection
• Load medical records and reports from provider offices into the HEDIS application
• Provide subject matter expertise in project management and coordination for medical record identification, pursuit, and collection
• Support annual HEDIS audit and other audits by organizing provider outreach, pursuit, collection, and upload of medical records
• Assist medical records leadership and quality improvement staff with physician and member interventions and incentive efforts
• Provide mentorship and leadership to team members on process and project improvement initiatives
• Participate in and prepare feedback for meetings with vendors related to medical record collection
• Undertake medical records collection related travel as required

Requirements

• 4+ years of healthcare experience, including medical records support in managed care
• Valid and unrestricted driver's license, reliable transportation, and adequate auto insurance
• Latest CMS and AHA clinic coding knowledge
• Ability to maintain confidentiality and comply with HIPAA
• Knowledge of HEDIS and NCQA
• Proficiency with data analysis tools (e.g., Excel)
• Excellent customer service and active listening skills
• Previous project coordination and/or process improvement experience
• Ability to effectively interface with staff, clinicians, and leadership
• Strong prioritization skills and detail orientation
• Strong verbal and written communication skills, including professional phone etiquette
• Microsoft Office suite/applicable software program(s) proficiency

Qualifications

• At least 4 years of health care experience, including medical records support in a managed care setting, or equivalent

Nice to Have

• Healthcare Effectiveness Data Information Set (HEDIS) data collection experience

Skills

* Required skills

Benefits