"Alerted.org

Duration: 2-3 months contract

Start Date: Feb 9** **th** **2026

Overview

+ Under the general direction of the Quality Program Manager(s), the Medical Claims Research Specialist(s) will review medical claims reports to help identify the appropriate medical record(s) and/or provider(s), and document follow-up actions during the HEDIS (Healthcare Effectiveness Data Information Set) reporting period.

Principal Duties and Responsibilities

+ Willingness to learn basic principles of the HEDIS medical record clinical measurement via internal trainings

+ Follow internal workflows to complete daily project tasks

+ Conduct claims and provider research using claims reports

+ Document and track claims research steps and outcomes using MS Excel, and HEDIS software platform Validate and document provider location

+ Fax HEDIS requests to medical office locations

Other Functions

+ Collaborates with all HEDIS team members to reach project goals

+ Completes follow-up phone calls as needed

+ Attends HEDIS project staff meetings

+ Other duties may be assigned by HEDIS team leadership

Education and Preferred Skills

+ High school diploma or equivalent

+ Experience with medical terminology and provider specialties

+ Experience working in medical claims systems

+ Healthcare experience (including HEDIS)

+ Experience in a call center, customer service environment, or phone-related experience

Required Skills

+ Proficiency with Microsoft Office Suite (MS Outlook, MS Excel) and other computer applications

+ Capable of quick learning

+ Ability to follow complex workflow instructions

+ Informed decision-making and problem-solving skills

+ Must be able to write and speak clearly and effectively to peers and clinical staff

+ Excellent interpersonal and communication skills

+ Data entry and typing skills

+ Highly organized

+ Detail-Oriented

+ Self-motivated with ability to work independently

+ Able to manage multiple activities simultaneously

Working Conditions or Additional Requirements

+ Remote work · Adhere to all privacy and confidentiality policies in accordance with organizational guidelines · Secure internet connection required

About US Tech Solutions:

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com (http://www.ustechsolutionsinc.com) .

US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.