HEDIS Reviewer III

Job Title: HEDIS Reviewer III
Location: Remote, RI 02895
Duration: 4 Months+ (with possibility of extension)

Pay Rate: $40.97/hr. on W2

Schedule: Monday – Friday, 8:00 AM – 5:00 PM (Local Time)
 
Equipment Provided: Yes
Training: Remote – mandatory attendance required
 
Position Summary:
We are seeking an experienced and detail-oriented HEDIS Reviewer III to support HEDIS quality reporting initiatives through comprehensive medical record review (MRR) and data abstraction. This is a work-from-home position with occasional local travel to provider sites in Michigan, so candidates must live in or near the state.
You will play a critical role in interpreting clinical documentation, abstracting medical data, annotating records using Adobe PDF, and entering data into proprietary HEDIS tools. This position requires high attention to detail, medical knowledge, and the ability to work independently in a highly regulated environment.
 
Primary Responsibilities:

• Abstract clinical information from medical records for HEDIS reporting
• Annotate medical records via Adobe PDF per training guidelines
• Accurately enter data into HEDIS platforms/tools
• Schedule and coordinate with provider offices as needed
• Follow up on missing or incomplete medical records/documentation
• Prioritize tasks, meet productivity and quality benchmarks daily
• Maintain confidentiality in line with HIPAA and security policies

 
Required Skills & Experience:

• 4+ HEDIS seasons of abstraction and medical record review experience required
• Medical terminology and the ability to interpret clinical documentation essential
• Strong proficiency with Adobe PDF, Microsoft Word, Excel, Outlook
• Strong attention to detail, time management, and analytical skills
• Excellent written and verbal communication skills
• Ability to work independently, meet deadlines, and solve problems
• Comfortable with 100% computer-based work and managing sensitive health data
• Ability to lift equipment up to 25 lbs and travel locally as required
• Must have a private, secure workspace and reliable high-speed internet with the ability to connect via Ethernet (not Wi-Fi)

 
Work Environment Requirements:

• Workspace to accommodate a laptop and two monitors
• Uninterrupted private space for handling confidential PHI
• Must return all equipment in good condition post-project

 
Preferred Qualifications:

• Experience using handheld scanners, iPods, flash drives for record collection
• Familiarity with CMS performance measures and regulatory compliance
• Previous work scheduling provider appointments or abstracting in a remote environment

 
Pre-Screening Questions for Candidates:

1. Is the name on your resume your legal name? If not, please provide.
2. Do you have an alternate phone number?
3. Can you commit to full-time work (M–F, 8–5) from January through May without interruption?
4. Do you have any planned time off during that period?
5. List 3 Microsoft Office programs you're proficient in and how many years you've used each.
6. Can you connect your work laptop to your modem using Ethernet (not Wi-Fi)?
7. Can you lift and transport up to 25 lbs of equipment?