HEDIS Reviewer III

Participates in the collection and review of medical records to abstract clinical information for HEDIS quality reporting of the IFP Team
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.



Please have your candidates fill out the 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)



Position Summary:



Participates in the collection and review of medical records to abstract clinical information for HEDIS quality reporting of the IFP team
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:



RN or LPN