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HEDIS Specialist
abstracted data for accuracy and compliance Apply HEDIS specifications and regulatory requirements Requirements: Strong understanding of HEDIS measures and specifications Experience with medical records abstraction and data analysis Knowledge of medical...terminology and coding guidelines Familiarity with regulatory requirements
Medical Claims Coordinator
claim payments and communicate decisions with third-party administrators Monitor claim trends, generate reports, and perform self-audits to improve accuracy and efficiency Qualifications High School Diploma or GED required; Bachelor's degree in Medical...Billing and Coding or related field preferred Minimum 5 years of experience in medical claims administration Familiarity with medical terminology and third-party administration processes Proficiency in Microsoft Office and relevant computer applications
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