Fort Lauderdale, Florida, USA
28 USD – 32 USD/Hour
- Work with HEDIS team to collect member records and conduct reviews of these records by contacting providers and placing the results collected into a specific data base.
- Required to handle a high volume of telephonic interaction with provider offices.
- Required to perform research on internal claims systems.
- Must be flexible and willing to develop and share strategies to accomplish goals.
- Work under the supervision of internal staff and designated lead in order to achieve goals and keep the project moving.
- Reviews require data analysis and research within the data systems.
- Candidates must have excellent skill set to read and interpret physician handwriting.
- Candidates must have critical thinking skills as they will conduct research in a thoughtful and methodical search in order to locate specific claim information.
Additional Skills & Qualifications:
- A licensed nurse (RN, LPN, LVN)
- Licensed professional graduate of an accredited school of nursing (Associates)
- Analysis skills
- Prior knowledge of codes used to services based on diagnosis and procedure
- Type 30+ WPM
- Effective written/oral/interpersonal communications
- Knowledge of Microsoft Office (Excel)
- Live in the state of FL as local travel/team meetings may be required
Prior HEDIS experience a plus
Diversity, Equity & Inclusion
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
- Hiring diverse talent
- Maintaining an inclusive environment through persistent self-reflection
- Building a culture of care, engagement, and recognition with clear outcomes
- Ensuring growth opportunities for our people
Actalent is an equal opportunity employer.
Actalent connects passion with purpose. We help visionary companies advance their engineering and science initiatives through access to specialized experts that drive scale, innovation, and speed to market. With a network of almost 30,000 engineering and sciences consultants and more than 4,500 clients across the U.S., Canada, Asia, and Europe, Actalent serves many of the Fortune 500. An operating company of Allegis Group, the global leader in talent solutions, Actalent launched as a new specialized engineering and sciences services and workforce solutions brand in 2021.
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