HEDIS Reviewer III
Work from home position.
HEDIS Medical Record Review (MRR) Abstractor III
Participates in the review of medical records to abstract/data entry clinical information for HEDIS quality reporting.
This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool (Inovalon/QSHR) to support compliance with HEDIS and CMS performance measures. Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements. The candidate must be proficient with databases and with conducting 100% of work activities on the computer.
* Reliable internet connection is mandatory
* Must commit to duration of the project with the understanding that work hours can be varied.
* Candidate must available during working hours and commit to attend all required training and video conference calls assigned for the project.
* Due to proprietary information, must inform employer if they are planning to accept employment with another company.
* 4 or more years of experience auditing and abstracting medical records required, HEDIS experience a plus
* Medical knowledge/terminology is a plus.
* Ability to read and interpret medical records.
* Professional demeanor and good work ethic.
* Working knowledge of Microsoft Word, Excel, Outlook, and Microsoft Explorer (experience creating folders, and saving documents/files to folders)
* Adobe/PDF tools (commenting/ annotating) required.
* Excellent verbal and written communication skills - clear, concise and appropriate.
* Conscientious problem solver, willing to learn, and take personal pride in their work performance /accuracy.
* Exceptional attention to detail and excellent analytical, investigation, and problem-solving skills
* Proven organizational and time management skills including the ability to meet required deadlines
* Must keep all information collected in a safe, organized and confidential manner while maintaining confidentiality of PHI, HIPAA Privacy and Security Rules
* Workspace able to accommodate laptop and up to 2 monitors
* Private uninterrupted workspace to maintain HIPAA Privacy and Security Rules
* Must maintain a professional appearance during all virtual meetings.
* Working knowledge and experience required with laptops in order to collect, save, rename, and transfer confidential information.
* Locate and review all supporting documentation from the internal Case Management system (Dynamo)
*Perform abstraction, copy all supporting documentation into designated folders per specifications, and data enter into the applicable software system (Inovalon/QSHR) assigned abstracts.
*Prioritize and accurately complete tasks within established times
* Complete assigned abstraction and data entry each day.
* Maintaining project productivity levels while maintaining accuracy requirements for abstraction and data entry activities
* Candidate must return all equipment that is supplied to them in good working condition and in a timely manner at the end of the project.