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HEDIS Clerk III

Spectraforce Technologies
United States, North Carolina, Raleigh
500 West Peace Street (Show on map)
Sep 03, 2025
Title: HEDIS Clerk III

Duration: 4+ months

REMOTE


* Excel and Typing (speed and accuracy) Assessment Scores to be provided on Questionnaire

* Remote- City and state must be on resumes. Hours for training and working will be CST.


SUMMARY DESCRIPTION:

The Clerk III staff will work under the supervision of the Senior Director or department designee and serve as a liaison between the medical record review team and provider office staff. Outreach calls are made to provider offices to request medical records required for medical record abstractions by the medical record review team. Records received are uploaded and stored in an internal provider outreach database for review by the Clerk III to assigning to the medical review team.

Essential Functions:

Conduct provider outreach calls to request medical records. Enter key performance metrics into an internal database including, but not limited to the number of calls made, medical records received and provider contact information. In addition, retrieve charts from approved EMR's and portals. Upload incoming medical records into the provider outreach database. Use correct naming conventions, save and manage files on a shared medical record drive and other project documents as assigned.

JOB REQUIREMENTS:

High School Diploma or GED

2 years' experience making outbound and receiving inbound calls

Customer service skills

Data entry experience

Proficiency in PDF, Word and Excel

Excellent written and communication skills

Duties and Responsibilities:

Request medical record data via fax, email and USPS mail

Scan paper documents obtained from USPS mail or fax to the provider outreach database

Label documents as directed by the Senior Director/designee and place in appropriate measure file

Utilize various software applications to support HEDIS survey operations

Attend scheduled meetings with HEDIS Project Manager, and /or Quality Management Specialist/ designee to discuss project status, open issues and productivity

Maintain open and honest communication with management/designee regarding development or assistance needed throughout project

Conduct follow-up calls to provider offices to follow-up on aged medical record request

Escalate work related challenges/issues to Senior Director or designee

Maintain compliance with PHI, HIPAA and patient confidentiality requirements

Other duties as assigned

Preferred Skills:

Medical Assistant certification

Medical terminology knowledge.

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