Medical Claims Research Specialist job at US Tech Solutions in Canton, MA
Title: Medical Claims Research Specialist
Location: MA-Canton
$22.00-$22.75 per hour
Fully Remote
ContractStarts 2/09/2026Ends 4/24/2026
Job Description:
Duration: 2-3 months contract
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 .
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.
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