Quality Review Operations Job at Robert Half in Minneapolis

As a Quality Review Operations, you will be working on HEDIS data collection efforts, managing data within Excel spreadsheets, and conducting provider outreach.

Responsibilities

• Conduct provider outreach, both by telephone and in writing, to confirm medical record requests and maintain accurate documentation.

• Manage and update data organized within Excel spreadsheets, using filtering, sorting, and VLOOKUP functions as needed.

• Request and follow up on medical records within database tools.

• Conduct research through internal electronic systems and reports to determine bulk conversion instructions.

• Adhere to HIPAA standards and maintain the confidentiality of protected health information, reporting any critical incidents immediately.

• Perform tasks assigned by supervisors for market-specific annual data collection efforts.

• Successfully complete two weeks of training, gaining proficiency in multiple electronic platforms.

This role will require a strong understanding of Microsoft Office, excellent communication skills, and the ability to work independently. Proficiency in research, time management, and problem-solving is also crucial.

• Proficiency in Microsoft Office Suites, including Excel, Word, and Outlook
• Experience in conducting both inbound and outbound calls
• Strong knowledge of database management
• Excellent training skills to educate team members and stakeholders
• Ability to perform in-depth research and review of data
• Familiarity with internet usage and online tools like HealthCare.gov
• Experience working with vendors and claim administration
• Proficiency in using spreadsheets for data analysis and reporting
• Excellent communication skills, both written and oral
• Strong time management and prioritization skills
• Knowledge of consumer electronics
• Understanding of the importance of confidentiality in a healthcare setting
• Proficiency in managing medical records
• Familiarity with HIPAA-regulated environments
• General computer skills
• Operational skills and understanding of healthcare operations.