QM Operations Clerk

Job Title: QM Operations Clerk

Location: New York, NY, 10004

Job Duration: 3 months with possible extension

Shift Time: 9am to 5PM Hybrid

Pay Rate: $20-$24/hr. on w2

Note: The position may require travel within the five boroughs within NY area.

Job Description:

· The primary function of the QM Operations Clerk - Seasonal is to function as administrative and technical support of the annual Medical Record Review project required to report HEDIS/QARR measures to the NYS Department of Health and Centers for Medicare & Medicaid Services (CMS). The role is field-based and seasonal (November of the measurement year through May of the reporting year), approximately seven months.

· The position will be responsible for processing incoming medical charts via multiple methods (fax, mail, email, onsite abstraction) and ensuring all systems are synchronized. The role requires a technically savvy individual who can multi-task accurately while conducting telephonic outreach to providers to schedule onsite retrieval, follow up on requests for medical charts and process incoming documents. The person may also be required to conduct onsite abstraction of medical charts in provider offices throughout the NYC area.

Product of Role & Responsibilities:

• Maintain knowledge of medical record review and EMR systems.
• Proficiency in MS Office applications, scanning and accurate data entry into client Health Plan systems
• Process incoming medical charts via email, fax, mail. Data enter receipt in the appropriate system(s) in accordance with established documentation standards for client Health Plan to ensure integrity of member services provided over the continuum of care and over time.
• Distribute requests for records and schedule appointments with provider offices to ensure timely completion of duties to meet internal and regulatory standards and requirements. Conduct follow-up of medical chart requests with provider offices to ensure the chart retrieval goal is met
• Perform abstraction via EMR, in-house paper medical records, on-site provider visits to collect documentation of measure compliance.