HEDIS Retrieval Specialist - Robert Half

Description We are offering a long term contract employment opportunity in the Healthcare industry. This role is for a Retrieval Specialist who will be instrumental in enhancing the quality of our services through data collection and provider outreach. You will be a crucial part of our team, ensuring the smooth operation of our services and delivering exceptional results. Responsibilities: - Assist with data collection efforts specific to our market - Conduct provider outreach to verify and confirm provider demographics and medical record requests - Perform medical record reviews for risk adjustment, HEDIS and HEDIS-like measures via remote EMR access or onsite - Schedule on-site reviews with provider offices, medical groups and other clinical facilities depending on geographical location - Maintain HIPAA standards and confidentiality of protected health information - Conduct claims research to determine correct service location or verify member history - Perform duties as assigned by Operations Manager or Director for market specific annual data collection efforts - Demonstrate proficiency in Microsoft Office: Outlook Excel and Word and similar applications to manage various data organized within Excel spreadsheets - Maintain strong communication skills in a virtual environment and across time zones - Adhere to productivity requirements in a high production environment.Responsibilities: + Acts as contract employee working a required 40 hours weekly schedule onsite or virtually focused on risk and/or HEDIS® data collection efforts + Performs duties as assigned by Operations Manager, or Director for market specific annual data collection efforts + Demonstrates effective professional verbal and written communication skills in a virtual environment and across time zones + Demonstrates proficiency in Microsoft Office: Outlook, Excel, and Word and similar applications + Manages various data organized within Excel spreadsheets + Conducts claims research, determining correct service location or verifying member history + Performs provider outreach, verifying and confirming provider demographics & medical record requests, both by telephone and in writing + Requests medical records and performs follow up of requests within database tools + Maintains HIPAA standards and confidentiality of protected health information; reports critical incidents immediately + Performs medical record reviews for risk adjustment, HEDIS® and HEDIS®-like measures via remote EMR access or onsite + Schedules on-site reviews with provider offices, medical groups, and other clinical facilities depending on geographical location + May require minimal travel to medical facilities from January - May in specified area of region to complete chart reviews; overnight stays may be necessary depending on travel from geographical location Requirements Required Qualifications: + High school diploma or equivalent + Designated workplace inside home (virtual) + Reliable internet connection (virtual) + Strong Communication Skills + Ability to contact providers and request data independently, by telephone and in writing + Experience and confidence with placing outbound phone calls + Proficient in Microsoft Office applications including Excel, Outlook, Word + Solid research skills + Excellent time management and prioritization skills + Results-driven independent worker and self-starter + Comfortable working in a virtual environment and across time zones + Comfortable working with laptop vs desktop + Flexible; self-directed learning approaches and adaptability are key + High level of organization skills, including attention to detail + Able to accept direction, duties and changing priorities as assigned + Excellent time management and prioritization skills + Requires use of personal vehicle if onsite travel is needed + Valid driver's license required when personal vehicle use is necessary Robert Half is the world's first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles. Robert Half works to put you in the best position to succeed. We provide access to top jobs, competitive compensation and benefits, and free online training. Stay on top of every opportunity - whenever you choose - even on the go. Download the Robert Half app (https://www.roberthalf.com/us/en/mobile-app) and get 1-tap apply, notifications of AI-matched jobs, and much more. All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information. © 2024 Robert Half. An Equal Opportunity Employer. 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