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