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Management Customer Service

United States
... Record systems in capturing healthcare outcomes data $ Expertise in regulatory agency interface, including JCAHO, OSHA, NCQA/HEDIS, HCFA, HIPAA (Privacy Rules and Regulations, Administrative Simplification and Coding), ICD $ Experience in complex ... - Sep 15

Health Staff

Troy, MI
... Roughly $6M paid out to PCPs during my tenure, resulting in 30% improvement in HEDIS scores, GDR usage up 20%, ER usage down 8%, 10% reduction in LOS - in the first year of the P4P. . Participated with management in the development of the Plan's ... - Sep 08

Sql Server Management

San Jose, CA
... design, development and testing of various healthcare softwares namely MVS, MSR, and HEDIS healthcare softwares right from its inception using VB.NET, ASP.NET 2.0, SQL Server 2000/2005, VBA, Crystal Reports, Business Objects, SSIS and SSRS. ... - Sep 07

Customer Service Sales

United States
... Clinical Operations Microsoft Office ACT Project Management CRM Easy Dental Quality improvement/assurance NCQA/HEDIS Practice Works HIPAA Compliance OSHA Compliance EagleSoft Medicare/Medicaid EMR Provider Relations Contract negotiations ... - Sep 04

Medical Training

Denver, CO
... modification * HEDIS/MRA EMR retrieval procedures, case/records management, medical terminology * Proven ability to work effectively with third party administrators, workforce, human resources, pre-employment, union and operational management. ... - Sep 03

Customer Service Manager

Stockton, CA
... and risk groups • Successfully facilitate/implement various initiatives with groups (HEDIS, MRA, STARS, etc.) MGK Insurance, Senior VP Of Benefits 2013- 2009 • Successfully positioned company as a competent leader in the small group employer arena. ... - Sep 03

Medical Assistant Management

United States
... • Medicare Risk Adjustment (MRA) • Comprehensive Primary Care Initiative (CPCI) • Healthcare Effectiveness Data and Information Set (HEDIS) • Centers for Medicare and Medicaid Services (CMS) • Proficient in Excel, Word, Access, CAS, EMPI, PAAG, CGX - Sep 01

Customer Service Administrative Assistant

Roswell, GA
... member’s medical records for Risk Adjustment Data Validation audit Contacted provider offices in an assigned territory to schedule medical record reviews for HEDIS(Healthcare Effectiveness Data and Information Set) and PIA (Payment Integrity Audit). ... - Aug 31

Data Analyst

Thousand Oaks, CA
... Gather technical requirements from multiple teams and departments to coordinate reporting efforts Pull data from multiple sources (TSI, Eclypsis, HEDIS, and Financial databases), transform and input data into SAS based Balanced Scorecard system. ... - Aug 31

Human Resources Professional

Forest Park, GA
... and software programs quickly EMPLOYMENT HUMANA Atlanta, GA April 2012 – Present Specialist •Organize/conduct chart audits with physicians and/or office administrators for the purpose of completing HEDIS, MRA, and MCCI accreditation standards. ... - Aug 19

Customer Service Representative

Clayton, NC
... 02/2013- 05/2013 Cigna Insurance HEDIS Administrative Assistant Contact health care professionals to request the medical records of patient’s that were seen in their office during 2012, and abstract the necessary information needed to comply with ... - Aug 19

Database Analyst, Sql Server, T-SQL, SQL, Access, Excel, SSMS

United States
... membership and claims data from WellPoint Health Networks with BlueChoice HealthPlan’s provider network in preparation for HEDIS audits Developed complex statistical reports, charts, pivot tables and spreadsheets identifying trends in HEDIS measures ... - Aug 19

Sales Sql Server

WI
... • Developed a Medical Records Review Administrative Database application for the Quality Improvement department to collect medical record review data for HEDIS/QARR and MEDS each reporting year. The database is created according to NCQA requirements ... - Aug 15

Medical Assistant Manager

United States
... 2012-Feb 2013 HEDIS, Field Chart Reviewer Simply Healthcare Plans June 2010-August 2012 Field Case Manager in Broward and Dade Counties Hospitals, Coded Diagnosis and Procedure (ICD-9, CPT) Reviewed Charts in Broward and Dade Counties PCP's and ... - Aug 13

Customer Service Medical Assistant

Kissimmee, FL
... • Excellent communication skills/Strong team player • Supervisory/Training experience • Cash handling and customer service experience • HEDIS Stars and Wellcare visits WORK EXPERIENCE AWARDS: MILITARY EXPERIENCE: Chappel Family Practice May2014 ... - Aug 11

Registered Nurse Medical

Englewood, CO
... Employment 2014- 2014 HEDIS Medical Record Review Cigna Insurance Company. 500 Southborough Drive #302 South Portland, Maine 04106. HEDIS Medical Record Review. 2006-2013 - ******* Legal Nurse Consulting. 1 Noonan Drive, Londonderry, New Hampshire ... - Aug 03

Customer Service Medical

Conyers, GA
... Knowledge of HEDIS Measures, NCQA compliance on Quality Assurance in patient care, HIPAA and PHI. Experience working with EHR systems. Detail oriented with great customer and client service skills. Team oriented with the ability to multitask and ... - Jul 31

Administrative Assistant High School

Kissimmee, FL
... I am also trained in medical billing, HEDIS measures, CPT & CPT II codes (F codes), ICD 9 codes, and Encounter codes. I have over thirty clinical offices running the EHR software on M3 mode, that’s on meaning full use; most of them are waiting for ... - Jul 30

Registered Nurse Medical

Methuen, MA
... *-*** Methuen, MA 01844 (978) ***-**** Experience Nurse Reviewer 11/2012 - 10/17/2013 Medix Staffing Solutions, HMS Permidion, Charlestown, MA Temporary contract Utilization Review - see nurse reviewer details below for responsibilities HEDIS Review ... - Jul 29

Data Entry Project

Jacksonville, FL
... Jan Rowe RN **** ********* ***** ************, ** 32256 904-***-**** ace2ik@r.postjobfree.com Cardiac Triage RN Experience Florida Blue RN HEDIS project February 2014--May 2014 RN telephonic Case Management and Data Collection Working closely with ... - Jul 22
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