HEDIS Call/Fax in Chicago, IL at CRS Group

Date Posted: 1/13/2020

Job Snapshot

  • Employee Type:
  • Location:
    Chicago, IL
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:

Job Description

HEDIS Call/Fax
Duration: contract
Location: Chicago, IL 60601
Overview: The CRS Group is currently looking for a HEDIS Call/Fax consultant for one of our clients in the Chicagoland area. The CRS Group is a nationwide Staffing Firm who works primarily with Fortune 500 and Fortune 1000 corporations.
Job Description:
We are looking for staff with clinical experience, who will be working under the supervision of the HEDIS Coordinator. They are a member of the medical record review team. The team is responsible for obtaining and performing accurate comprehensive reviews of medical records in support of The HEDIS Effectiveness Data and Information Set project. HEDIS reviews are completed in accordance with NCQA guidelines and technical specifications.  

Duties and Responsibilities:
  • Initiates phone calls to providers to follow-up faxed request for medical records.
  • Generate provider letters for request for medical records.
  • Initiates Fax Cover Page and Provider letters for medical records request.
  • Identifies and communicates patterns of missing documentation for the assessment of additional records. This entails phoning and faxing medical offices to obtain further information.
  • Utilizes various software applications to support HEDIS operations by entering data or changing chase status pertaining for the identified chase(s).
  • Meets with HEDIS Coordinator and / or QI Specialists to discuss HEDIS efforts, any open issues and can include IRR results.
  • Routes all exclusions and complex issues to the Quality Improvement Specialists/HEDIS Coordinator.
  • Maintains compliance with HIPAA and patient confidentiality requirements.
  • All other duties as assigned.

  • High School Diploma or GED.
  • Knowledge of medical terminology
  • Customer service skills
  • Data entry and/or typing experience.
  • Clear and concise written and verbal communication skills.
  • PC proficiency to include Word, Excel and Lotus Notes.

ss # 85903
Qualified applicants will receive consideration for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or genetic information.