• - Managed Care
  • Indianapolis, IN, USA
  • Full Time

RepuCare is a woman-owned business (certified WBE) and a leading provider of medical management solutions for federal and corporate healthcare programs. We are partnered with a large managed care company to provide medical management staff to support their state sponsored Medicaid program.

This is a contract position, at full time hours, beginning immediately and ending in May.  This is a great opportunity to gain some great experience with a large managed care company!

Job Responsibilities:

  • Schedule appointments with the providers in a designated territory and responsible for research and assisting with medical records
  • Enter and scan pertinent and supporting information from the medical record into a laptop application
  • Performs over-reads on HEDIS records
  • Utilizes NCQA, HEDIS Technical specification to optimize Plan HEDIS scores (will be trained on this)
  • Performs complete and accurate data entry of qualifying services and results into HEDIS electronic database software
  • Identifies and communicates patterns of missing documentation for the assessment of additional records
  • Successfully completes Medical Record Reviewer Training and Testing

Experience and Qualifications:

This is a high production environment and candidates must adhere to measured productivity requirements.

Must be flexible and willing to develop and share strategies to accomplish goals.  Local travel may be required.

  • Medical record review experience helpful, HEDIS experience helpful
  • Maintain compliance with all HIPPA and patient confidentiality requirements
  • Strong computer experience
  • Ability to work 40 hours per week
  • Ability to fax/scan/do data entry
  • Ability to work independently with minimal direction after training, but able to work cohesively with team as well

This position has been closed and is no longer available.


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