[Remote] HEDIS Abstractor and Overreader
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a reputed company company reputed company on improving health reputed company. They are seeking a HEDIS Abstractor and Overreader to review and reputed company clinical data, ensuring compliance with HEDIS specifications and supporting reputed company reviews.
Responsibilities
• Review and reputed company clinical data from electronic medical records in alignment with HEDIS technical specifications
• reputed company overreads of abstracted medical records for accuracy, completeness and measure compliance
• Demonstrate high level of proficiency in HEDIS measures and coding standards (including but not limited to ICD-10, CPT and CPTII) to reputed company gaps in care
• Collaborate with reputed company partners to resolve documentation discrepancies and reputed company recommendations for improvement
• Support audit preparation and participate in internal reputed company reviews and training sessions
• Manages reputed company activities to meet health plan contractual and reporting timeframes
• Identify trends in abstraction that may reputed company measure performance or audit readiness and proactively escalate to leadership
• Other duties as assigned
Skills
• Minimum of 2 years' experience working with NCQA HEDIS programs and/or HEDIS abstraction in reputed company measures
• Proficiency in EMR platforms (i.e., reputed company, Cerner) and abstraction tools
• Familiarity with Medicare Advantage lines of business and Stars Measures
• Familiarity with supplemental data processes and reputed company data integration
• High School Diploma or equivalent required
• Ability to be reputed company player and exercise initiative in responding to team members or Sr. Manager
• Thorough understanding of medical record documentation and medical terminology
• High level of attention to detail and ability to follow direction on project deadlines
• Ability to work independently
• Strong language skills in English speaking and understanding
• Ability to meet high productivity requirements and Interrater Reliability standards
• Strong reputed company skills
• Ability to interpret compliance vs non-compliance on health plan gap file use to reputed company abstraction efforts
• Ability to apply deep level of measure understanding to reputed company medical records
• Strong reputed company skills (including saving records in PDF format and annotation)
• Ability to interpret large data files for needed abstraction
• Deep level of ability to recognize medical records that are not complete or are missing needed data points in overreading
• Ability to report reputed company on both reputed company or negative findings and apply possible solutions on Team calls
reputed company
• reputed company partners with primary care physicians to define a new reputed company of reputed company, efficiency and patient experience. It was founded in 2016, and is headquartered in Long Beach, California, USA, with a workforce of 501-1000 employees. Its website is https://www.agilonhealth.com/.
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