Job Details

Molina's Hedis/Quality Improvement Sr. Medical Records Collector

Molina's HEDIS/Quality Improvement Sr. Medical Records Collector is a team member with several years experience in working collaboratively with outreaching to providers in order to pursue medical records via phone call, fax, mail, electronic medical record system retrieval and direct onsite pick up, for the HEDIS projects. These team members help mentor other team members and take the lead on process and project improvement. These team members act as the subject matter experts in the area of medical record collection/pursuit.

Job duties include:

• Under the direction of the national and/or regional lead, the medical records collector supports the annual HEDIS audit and other HEDIS like audits, by organizing provider outreach, pursuit, collection and upload of provider medical records into the internal database.
• Subject matter expert in the area of project management/coordination of the identification, pursuit and collection of medical records and other data in collaboration with other HEDIS staff.
• Assists the manager and supervisor(s) and/or performs the coordination and preparation of the HEDIS medical record collection process that includes the pursuit via phone call, fax, mail, electronic medical record system retrieval and direct onsite pick up.
• Participates and prepared feedback for the vendor meetings in relation to the medical record collection process.
• Subject matter expert in the area of collecting medical records and reports from provider offices, loads data into the HEDIS application.
• Assists the manager/lead and quality improvement staff with physician and member interventions and incentive efforts as needed through review of medical records documentation.

Job qualifications:

High school diploma or equivalent. Required experience/knowledge, skills and abilities:

• 3+ seasons/years medical record collection experience.
• 3+ years managed care experience.
• Basic knowledge of HEDIS and NCQA.

Required license, certification, association:

• Must have valid driver's license with good driving record and be able to drive within applicable state or locality with reliable transportation.

Preferred experience:

• 3 years HEDIS data collection experience.

Preferred license, certification, association:

• Certified medical record technician.

Physical demands:

Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.