Clin Admin Coordinator at The Judge Group Inc. in San Antonio, Texas

Job Description:

Location: San Antonio, TX

Salary: $19.00 USD Hourly - $20.00 USD Hourly

Description: HEDIS Operations Specialist




Location: Onsite position in San Antonio, TX



Schedule: Monday - Friday, 8 AM - 5 PM CST (occasional after-hours and weekend work required) Department: Quality SDS/PSV Operations



Training: 1-2 week training with limited time off (details to be discussed during interview) Experience Required: HEDIS®, DSNP, and Quality experience

Role Overview:



Join our dynamic HEDIS Operations team, which combines talented individuals from various quality areas, including HEDIS, CAHPS, and Accreditation. Our goal is to achieve extraordinary performance, exceeding the expectations of our stakeholders, customers, and members we serve. As a HEDIS Operations Specialist, you will assist the Quality SDS/PSV Operations staff with DSNP data collection.

Key Responsibilities:

• Conduct market-specific data mining, data entry, and collection.
  
  


• Perform medical record reviews and abstraction for HEDIS and HEDIS-like measures.
  
  


• Additional duties as assigned.
  
  

Daily Tasks:

• Verify clinical data elements for HEDIS reporting through medical record reviews.
  
  


• Identify findings supported by documentation guidelines with high accuracy.
  
  


• Maintain HIPAA standards and confidentiality of protected health information; report critical incidents immediately.
  
  


• Prioritize and organize work to meet deadlines.
  
  


• Communicate additional medical record pursuit leads to team members.
  
  


• Participate in conference calls to provide information on clinical reviews and compliance.
  
  


• Complete HEDIS technical specification training and testing successfully.
  
  


• Use HEDIS software correctly after training.
  
  


• Perform other tasks as assigned.
  
  

Essential Functions:

• Assist in reviewing medical records to highlight Star/HEDIS opportunities.
  
  


• Review medical records for data collection, data entry, and quality monitoring to close gaps in care.
  
  


• Partner with leadership, administrative, or clinical staff to identify trends and support practice strategies.
  
  


• Communicate challenges or trends that may negatively impact quality outcomes.
  
  


• Track and trend barriers/challenges to achieve better outcomes, including appointment access and coding practices.
  
  


• Navigate multiple documentation systems to obtain medical record sections supporting HEDIS/Star measures.
  
  


• Support quality initiatives by requesting medical records from providers' offices as needed.
  
  


• Respond to Clinical Quality inquiries via phone, fax, email, or other communication channels.
  
  


• Conduct inbound and outbound calls for quality requirements, including medical records requests and contact verification.
  
  


• Provide clerical and administrative support to quality staff and managers for special projects and reporting needs.
  
  


• Deliver excellent customer service and serve as a resource to internal and external customers.
  
  


• Maintain an up-to-date knowledge base of HEDIS/STARs.
  
  


• Engage in data mining activities.
  
  

Minimum Qualifications:

• High School Diploma or GED.
  
  


• Two years of administrative support experience.
  
  


• Proficiency in Microsoft Office applications (Excel, Word, Outlook).
  
  


• Ability to work independently with some supervision and direction from the manager.
  
  


• Knowledge of medical terminology.
  
  


• Excellent organizational and customer service skills, including verbal and written communication.
  
  


• High degree of professionalism in personal conduct and appearance.
  
  


• Strict confidentiality adherence.
  
  


• Compliance with all department/organizational policies and procedures.
  
  

Preferred Qualifications:

• Certified Medical Assistant training or certification.
  
  


• Two or more years of experience in a physician's clinic or hospital.
  
  


• Additional experience as a receptionist or medical assistant in a medical care setting.
  
  


• Bilingual proficiency in English and Spanish.
  
  


• Three or more years of experience with data analysis/quality chart reviews.
  
  


• One or more years of HEDIS/STAR experience or participation in similar quality regulatory reporting.
  
  


• Knowledge and experience with EMR and HEDIS.
  
  

By providing your phone number, you consent to: (1) receive automated text messages and calls from the Judge Group, Inc. and its affiliates (collectively "Judge") to such phone number regarding job opportunities, your job application, and for other related purposes. Message & data rates apply and message frequency may vary. Consistent with Judge's Privacy Policy, information obtained from your consent will not be shared with third parties for marketing/promotional purposes. Reply STOP to opt out of receiving telephone calls and text messages from Judge and HELP for help.



Contact: eturner@judge.com


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