HEDIS Reviewer III

Max Bill Rate = *** Potential travel based on location of hire and whether or not there is a need to assist in a location every now and then. Is not likely going to be needed. Participates in the collection and review of medical records to abstract clinical information for HEDIS quality reporting. Training will be provided prior to the start of the assignment. This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool 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. Must commit to duration of the project with the understanding that work hours can be varied. Due to proprietary information, must inform employer if they are planning to accept employment with another company. Work from home position, but may require onsite medical record collection visit to a provider's location in your area. Please have your candidate fill out the following Questionnaire and return with their resume: • Is the name listed on your resumes your legal name and spelt correctly, if not please provide that name? • Do you have an alternate phone number to what is already on your resume? • Are you able to work Monday thru Friday, 8 am to 5 pm your local time (January thru May) without interruption? • Do you have anything that requires time off or would prevent you from working the above required schedule (January thru May)? • Please list 3 different Microsoft Office Suite Programs you have experience with and how many years you've worked in each one. • Are you able to connect the Healthcare provided laptop to your home internet modem via an ethernet cable connection? (Not thru a WiFi connections) • Do you have the reliable transportation to travel to a provider's office, if needed? • Are you able to carry equipment that weigh up to 20lbs? • Once you have cleared all compliance items in the hiring process please provide a professional looking photo to Stacie Doughty and Brandon Rennard via email folowing this criteria for photos: -User will need to take a professional looking photo using a digital camera or phone. -Please ensure that your head, from the shoulders up, is shown. -Stand in front of a flat smooth solid colored wall (no photos in front of crowds or photos of a photo). -No hats, hoods, or scarves are to be worn (unless for religious purposes only). -Prescription glasses are fine; no sunglasses please. -Nothing sitting on top of the head. -Please save photo as a .JPG file and name the file First Name_Last Name -Please email your photo to *** and *** Position Summary: Participates in the collection and review of medical records to abstract clinical information for HEDIS quality reporting. Training will be provided prior to the start of the assignment. This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool 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. Must commit to duration of the project with the understanding that work hours can be varied. Due to proprietary information, must inform employer if they are planning to accept employment with another company. Duties: "• Complete assigned abstraction and data entry each day. • Work with provider offices as needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters • Locate and review ALL assigned medical charts, perform abstraction, copy all supporting documentation per specifications and data enter into the applicable software system ALL assigned abstracts. • Prioritize and accurately complete tasks within established times • Identifying trends and documentation of areas for improvement • Maintaining project productivity levels while maintaining accuracy requirements for abstraction and data entry activities" Experience: • 4 or more seasons of experience auditing and abstracting medical records required • Candidate must commit to attend all required training and conference calls assigned for the project. • 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 • Medical knowledge/terminology is required. • Ability to read and interpret medical records. • Professional demeanor and good work ethic. • Computer savvy: Microsoft Word, Excel, email, and Adobe reader required. Know how to save a file to a folder. • 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 Education: N/A

Created: 2024-11-05