Electronic Medical Records Coordinator

Description

Job Details : Reporting to the HEDIS Manager, the role of the Electronic Medical Records Coordinator is critical to the success of Blue Shield of California and HEDIS Operations in realizing its goals and objectives.

This individual will play a key role as part of the Clinical Quality Outreach team in delivering and collaborating on all aspects of HEDIS operations and medical record pursuit.

The Electronic Medical Records Coordinator role will also provide support to projects such as member outreach to close gaps in care and appointment coordination for member to ensure services are completed.

Specifically, the Electronic Medical Records Coordinator role will be accountable for :

Assist with quality improvement initiatives as needed.

Develop relationships with outside health care agencies to establish EMR connections and identify connectivity requirements collaborating with BSC IT Department to meet all requirements.

Address barriers to EMR access

Troubleshoot EMR access issues

Extract required HEDIS measure data from various EMR systems.

Conduct warm outreach calls to members and schedule visits with PCP / Specialists. Actively engage and empower members to take action needed to close care gaps for HEDIS compliance.

Request medical records from PCP / Specialists by fax, remote EMR access or scheduled site visits as needed.

Receive and review medical records for content prior to sending for clinical review and abstraction.

Manage and maintain HEDIS files and medical records.

Be an active part of the team and promote a positive work environment.

Prioritize tasks and projects to meet deadlines.

Track projects, accurately enter data, prepare, and generate reports

Provide feedback and regular status reports on assignments.

Provide administrative support, including generating correspondence, organize mass mailings, coordinator schedules and training.

Understanding of HEDIS hybrid measures and possess knowledge to conduct deep dive investigations to identify missing measure components in medical records.

Research provider information and claims using online websites and internal applications.

Continuous validation of provider data to ensure the accuracy of the location of medical records accuracy to ensure HEDIS project success.

Provide input for continual process improvement.

Assist in the current and ongoing assessment of provider office’s current practices and provide suggestions for streamlining and / or process improvements.

Qualifications

Education and Qualifications :

Minimum of 2 years of technical (or relevant) experience required

Minimum of 2 years customer service (or relevant) experience required

Minimum of 2 years of HEDIS experience preferred

Must be organized with the ability to keep accurate notes and records

Excellent verbal / written communication skills

Proficient in Microsoft Excel and Word

Physical RequirementsOffice Environment - roles involving part to full time schedule in Office Environment. Based in our physical offices and work from home office / deskwork Activity level : Sedentary, frequency most of work day.