HEDIS Specialist

The HEDIS Specialist provides vital administrative and operational support across various departments within the healthcare organization. This role encompasses duties typically performed by Client Account Administrators, Patient Access Representatives, and other general support functions. The Specialist ensures efficient operations by handling a range of tasks including patient access, account management, data entry, internal operation support, and customer service. This role is essential for maintaining the smooth functioning of the healthcare organization and enhancing patient and client satisfaction. 

HEDIS experience is not required, we are willing to train the right person. 

The day to day of the HEDIS Specialist consists of administrative work regarding patients' records, insurance, and other duties as assigned. A candidate with experience in Medical Records, Front Desk, Customer Service and Office Assistant are encouraged to apply. Candidates with great work ethic, ability to work multiple screens, are tech savvy, are also encouraged to apply.

DUTIES & RESPONSIBILITIES 

• Facilitate patient access by managing appointment scheduling, patient check-in/check-out processes, and verifying patient information. 


• Provide support for HEDIS (Healthcare Effectiveness Data and Information Set) data collection and reporting, ensuring accurate and timely data entry. 


• Assist in managing client accounts, including updating account information, processing payments, and addressing client inquiries. 


• Perform general administrative tasks such as answering phones, responding to emails, filing, and maintaining office supplies. 


• Support patient care coordination by liaising between patients, healthcare providers, and insurance companies to resolve issues and answer questions. 


• Conduct data entry and maintain accurate records in electronic health record (EHR) systems. 


• Assist in the preparation and distribution of reports, correspondence, and other documents as needed. 


• Ensure compliance with healthcare regulations and organizational policies. 


• Provide excellent customer service by addressing patients and client needs promptly and courteously. 


• Participate in team meetings and contribute to process improvement initiatives. 

• High school diploma or equivalent is required; associate’s degree or higher in healthcare administration or a related field is preferred. 


• Two (2) or more years of experience in administrative role, Client Account Administrator, or Patient Access Representative preferred.


• Proficiency in using electronic health record (EHR) systems and other healthcare management software. 


• Certification in medical coding, billing, or healthcare administration is a plus. 

• Strong organizational and time management skills, with the ability to prioritize tasks effectively. 


• Excellent written and verbal communication skills, with a customer-focused approach. 


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


• Ability to work independently and as part of a team, demonstrating flexibility and adaptability. 


• Attention to detail and accuracy in data entry and record-keeping. 


• Understanding of healthcare terminology, billing practices, and insurance processes. 


• Ability to handle sensitive information with confidentiality and professionalism. 


• Strong problem-solving skills and a proactive approach to addressing issues. 


• High level of integrity and ethical standards in dealing with patient and client information.


• Commitment to continuous learning and professional development. 

The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer.