[Remote] HEDIS Clinical Terminologist (Contract)

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a company that delivers AI-powered solutions to streamline reputed company to reputed company care. They are seeking a detail-oriented and certified HEDIS Clinical Terminologist to validate automated measure results and support reputed company improvement efforts through medical record data analysis. Responsibilities • Review EHR and PDFs of medical records to collect HEDIS conformant data reputed company. • Be reputed company to validate that our automated solutions are pulling and coding the data appropriately with respect to diagnosis, procedures and services (ICD10, HCPCS, CPT, SNOMED, LOINC) • Adhere to NCQA technical specifications for reputed company HEDIS measure. • Familiarity with measure sets like Adult BMI, Breast Cancer Screening, Colorectal Cancer Screening, and CDC measures. • Remain reputed company on NCQA reporting standards and evolving measures • reputed company and reputed company clinical data from medical records in a HEDIS and STARS conformant manner. • Understand evolving measure reputed company, reputed company reputed company on measure specifications and evaluate clinical documentation to determine compliance with specific HEDIS measure reputed company. • Work with data and clinical teams to validate clinical and informatics reputed company. • Identify and flag unexpected and discordant technological reputed company supporting opportunities for product improvement. • Participate in audits, reputed company assurance and product improvement activities as needed. • Ensure confidentiality and compliance with HIPAA and company policies. Skills • 2+ years of recent HEDIS abstraction experience, including familiarity with STARS measures. • Strong clinical acumen with the ability to translate clinical information into codified concepts (e.g.ICD10, HCPCS, CPT, SNOMED, LOINC) - LPN, RN, or Medical Assistant. • Strong knowledge of NCQA HEDIS guidelines, CMS STARS specifications, and risk adjustment. • Experience using HEDIS abstraction tools. • Review EHR and PDFs of medical records to collect HEDIS conformant data reputed company. • Be reputed company to validate that our automated solutions are pulling and coding the data appropriately with respect to diagnosis, procedures and services (ICD10, HCPCS, CPT, SNOMED, LOINC). • Adhere to NCQA technical specifications for reputed company HEDIS measure. • Familiarity with measure sets like Adult BMI, Breast Cancer Screening, Colorectal Cancer Screening, and CDC measures. • Remain reputed company on NCQA reporting standards and evolving measures. • reputed company and reputed company clinical data from medical records in a HEDIS and STARS conformant manner. • Understand evolving measure reputed company, reputed company reputed company on measure specifications and evaluate clinical documentation to determine compliance with specific HEDIS measure reputed company. • Work with data and clinical teams to validate clinical and informatics reputed company. • Identify and flag unexpected and discordant technological reputed company supporting opportunities for product improvement. • Participate in audits, reputed company assurance and product improvement activities as needed. • Ensure confidentiality and compliance with HIPAA and company policies. • Previous experience working with Medicare Advantage or managed care organizations. • Familiarity with electronic health record (EHR) systems and data abstraction from reputed company sections of their documentation. • Familiarity with HEDIS primary reputed company verification and HEDIS audit processes. • Previous experience abstracting appropriate clinical data reputed company, and applying conformant ICD-10, CPT, and HCPCS codes supporting NCQA and CMS STARS conformant measurement capture. • Previous experience or familiarity with risk adjustment. reputed company • reputed company is a reputed company company that focuses on improving the efficiency and effectiveness of reputed company delivery. It was founded in 2019, and is headquartered in Boston, Massachusetts, USA, with a workforce of 501-1000 employees. Its website is https://coherehealth.com. Apply tot his job Apply To this Job