Quality Medical Assistant, WellMed at White Rock - Dallas, TX
UnitedHealth Group
- Dallas, TX
- Permanent
- Full-time
- Assisting in the review of medical records to highlight Star/HEDIS opportunities for the medical staff
- Review medical records for data collection, data entry, and quality monitoring including health plan/WellMed form submission and chart collection activities that close gaps in care
- Partner with the leadership team, the practice administrative or clinical staff to identify trends observed and potential strategies to support the practice
- Communicate scheduling challenges or trends that may negatively impact quality outcomes
- Track and trend barriers/challenges that exist at their assigned groups so that better outcomes can be achieved including access to appointments, lack of follow up on referrals, or inconsistent billing practices
- Activities may include data collection, data entry, quality monitoring, health plan/WellMed form submission and chart collection activities
- Assists with local IRR audits
- Navigate multiple documentation systems and obtain medical record sections supportive of HEDIS/Star measures
- Support chart chase process by requesting records from provider’s offices as needed
- Maintains education/knowledge base of HEDIS/STARs
- Performs all other related duties as assigned
- Medical Assistant certification
- Current BLS certification
- 3+ years of healthcare experience to include experience in a managed care setting
- 3+ years of experience with data analysis/quality chart reviews. Must be able to review data and provide recommendations for improvement
- 2+ years as a Certified Medical Assistant
- Experienced using Microsoft office applications, including databases, word-processing, and excel spreadsheets
- Expert in computer literacy in electronic health record
- Knowledge of medical terminology
- Proven ability to mentor others
- This position requires Tuberculosis screening as well as proof of immunity to Measles, Mumps, Rubella, Varicella, Tetanus, Diphtheria, and Pertussis through lab confirmation of immunity, documented evidence of vaccination, or a doctor's diagnosis of disease
- Licensed Vocational/Registered Nurse, or Certified Professional Coder
- 2+ years of college, in pursuance of a Bachelor’s or Associate’s degree
- 2+ years of experience working with HEDIS/STAR measures
- 1+ years of HEDIS/STAR experience or participation with similar regulatory reporting
- ICD 9/10 and CPT coding experience
- Experience working in a physician, provider, and/or medical office
- EMR and HEDIS knowledge and experience
- Ability to lift up to 10 pounds
- Ability to push or pull heavy objects using up to 50 pounds of force
- Ability to stand for extended periods of time
- Ability to use fine motor skills to operate equipment and/or machinery
- Ability to receive and comprehend instructions verbally and/or in writing
- Ability to use logical reasoning for simple and complex problem solving