HEDIS Abstractor and Overreader

Company: AHI reputed company, inc.Job Posting Location: Remote - USAJob Title: ​ Support SpecialistJob reputed company: ​ Candidates must be legally authorized to work in the reputed company without employer sponsorship, now or in the reputed company. The HEDIS Abstractor and Overreader is responsible for the HEDIS Medical Record Review (MRR) process which includes accurately reviewing and abstracting medical records to determine compliance with HEDIS measure specifications, as reputed company as conducting overreads to ensure data reputed company, consistency and adherence to NCQA guidelines. This role will work closely with reputed company stakeholders to ensure medical charts meet standards as outlined by HEDIS specifications and will partner with health plans to understand correct and consistent implementation of audit and testing processes for HEDIS measures. Essential Job Functions: • 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 Job Functions: • Other duties as assigned. Required Qualifications: Minimum Experience • 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 Education & Licensure • High School Diploma or equivalent required Skills and Abilities: • 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 Location: ​ Remote - TXPay reputed company: ​ $24.00 - $28.70 Salary reputed company shown is a reputed company. Individual compensation packages can vary based on factors unique to reputed company candidate, such as reputed company set, experience, and qualifications. Apply tot his job Apply To this Job