HEDIS Abstractor (REMOTE/Nationwide)

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MAJOR DUTIES AND RESPONSIBILITIES:

  • Candidate will work with the HEDIS ® team to conduct medical record abstraction reviews of records. Additionally, reviews require data analysis and research within data/claims systems, along with critical thinking skills as they will conduct research in a thoughtful and methodical search in order to locate specific claim information.
  • Candidates must have excellent skill set to read and interpret physician handwriting. Results collected will be placed into specific database(s).
  • Candidates must work under the supervision of internal staff and designated lead in order to achieve goals and keep the project moving by adhering to measured productivity requirements. Module testing for HEDIS® specific measures may be required according to designated role.
  • Candidate must pass a medical record abstraction test prior to starting actual record reviews. Must be flexible and willing to develop and share strategies to accomplish goals.
  • Project is a timed study with tight deadlines that require high production/quality and staff committed to the entire season.


REQUIRED EXPERIENCE AND KNOWLEDGE:


  • Any combination of education and/or experience which would provide an equivalent background will be considered.
    Licensed nurse; RN, LPN, LVN, licensed professional graduate of an accredited school of nursing or other type healthcare background is preferred, not required.
  • Requires a strong knowledge of HEDIS® technical specifications and NCQA health plan accreditation guidelines (minimum 1- 2 years).
  • Excellent skillset for audit and abstraction of medical records
  • Demonstrated knowledge and experience in managed care membership, provider, and/or hospital systems preferred.
  • Candidates must have excellent computer skills and analysis capabilities, along with ability to log-on into multiple software as service tools and use of two computer (dual) monitors
  • Knowledge of Microsoft office is required (proficient in Word, Excel, Outlook)
  • Candidates must understand codes for services based on diagnosis and procedure in order to navigate CPT4 and ICD DX codes based on HEDIS® Technical Specification requirements.
  • Must be research and detail oriented with the tenacity to find medical record and claim specific data for a specific measure within a given period.
  • Requires effective written, oral, and interpersonal communication skills.
  • It is preferred that candidates can type 30-40 WPM.
  • Experience with Electronic Medical Record systems is a plus

Apply here!

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