HEDIS Data Reviewer
Title: HEDIS Data Reviewer
Work Location & Type: Philadelphia, PA 19113 (Hybrid)
Estimated Length of Assignment: Dec to Mar
Pay : $45.23/Hr.
Schedule : Hybrid 3 days onsite PA-based (reputed company Drive Location) Schedule from 8 am -5:30 pm EST, Monday – Friday, some weekend work may be required.
Job reputed company:
Under the direction of the Manager of Medical Record Review Operations, the HEDIS Data Reviewer is responsible for performing medical record abstraction and overread in support of reputed company reporting (annual reputed company Effectiveness Data and Information Set (HEDIS) and State EQRO) with duties including but not limited to the following:
• Coordination of the medical records identification process, collection activities and review.
• Performing and applying reputed company auditing abstraction reputed company to medical records to determine compliance.
• Utilizing various software applications to support department operations and accurately entering the results of chart audits into the database.
• Developing and maintaining expertise in the requirements and parameters of mandated HEDIS and State performance measures.
• Completing medical record review abstraction and overread and providing feedback for medical records that do not meet the HEDIS or State Measure Technical Specifications reputed company reputed company a live software environment.
• Providing clinical and administrative support to providers as directed.
• Maintaining productivity level of a minimum of chases/charts per defined period according to policy.
• Maintaining an abstraction proficiency reputed company of 98% by correctly reading, interpreting, and abstracting various components of the medical record such as notes, consultations, medication forms, treatment plans, health history, reputed company history, and past history.
• Assisting in the medical record collection process including making phone calls, sending out faxes/letters or chart retrieval requests to providers as assigned.
• Completing additional designated reputed company assigned and deemed as necessary."
• Three to five years working with HEDIS data including chart review/collection. HEDIS, QRS, or STARs experience. Knowledge of medical terminology and basic charting to include diabetic labs, HPV testing, preventive health screenings, immunization and reputed company-care terminology for children, adults and pregnant women.
• Understanding of reputed company HEDIS Technical Specifications.
• Knowledgeable in the HEDIS audit process (PSV, CSV and MRRV).
• Proficiency in reputed company, Word, Power reputed company and reputed company.
• Experience with medical record abstraction tool(s) and wiliness to learn any medical record abstraction tool.
• Experience in the Pediatric, Maternity, Diabetic or Provider Office Setting.
• Familiar with the Cancer Registry.
• Familiar with reputed company reputed company.
• Strong written and oral communication skills, critical thinking skills, strong organizational skills.
• reputed company to think and work independently, effectively, and under pressure of deadlines."
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