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HEDIS Abstractor in Southfield, MI at Integrated Resources, Inc

Date Posted: 9/14/2018

Job Snapshot

Job Description

The primary purpose of the job is to review, approve and provide feedback on documentation submitted by Providers to demonstrate Care Gap closure
Under the direction of Quality Management, the HEDIS Specialist is responsible to:
• Locate and review all assigned provider submitted medical records and perform abstraction according to NCQA HEDIS specification
• Complete the HEDIS Medical Record Review abstraction tool and provide feedback to providers for medical records that do not meet the HEDIS Technical Specifications requirement within a live software environment
• Provide clinical and administrative support to providers
• Maintain an abstraction proficiency by correctly reading, interpreting, and abstracting various components of the medical record such as notes, consultations, mediation, treatment, health history, interval history, and past history
• Partner with HEDIS Admin to accurately track records received and move records through review process

• RN, LPN, medical record professionals and coders will be considered
• Understanding of current HEDIS Technical Specifications
• HEDIS, QRS, or STARs experience
• Knowledge of medical terminology and basic charting to include diabetic labs, Pap smear and HPV testing, preventive health screenings, immunization and well care terminology
Minimum 4-5 years working with HEDIS data including:
• Chart review/collection
Additional experience but not required with:
• Excel, Word, and Outlook
• Any Medical Record Abstraction Tool
• Pediatric, Maternity, Diabetic Provider Office Setting
• MCIR
• MRRV process
• Bright Futures