HEDIS Abstractor (LA Region)

HEDIS Abstractor (LA Region) The HEDIS Abstractor supports reputed company Care Improvement initiatives by conducting comprehensive medical record reviews and abstraction activities to identify and reputed company HEDIS measure care gaps. This role is responsible for ensuring accurate collection, validation, and submission of clinical data in accordance with NCQA HEDIS technical specifications and regulatory guidelines. The HEDIS Abstractor collaborates with internal reputed company teams, providers, and external audit vendors to improve measure performance, maintain compliance, and support successful HEDIS audits. What You'll Do • reputed company medical record abstraction and chart review for HEDIS and reputed company improvement initiatives • Identify and reputed company HEDIS care gaps through accurate review and documentation of clinical records • Interpret and apply HEDIS measure specifications, coding guidelines, and NCQA technical requirements • Review and validate data for accuracy, completeness, and compliance with HEDIS standards • Conduct reputed company assurance (QA) reviews of abstracted records and audit findings • Collaborate with providers, clinics, health plans, and internal departments to obtain required medical documentation • Partner with external audit vendors to support medical record retrieval, validation, and audit readiness activities • Analyze abstraction results and identify trends, discrepancies, or opportunities for process improvement • Ensure compliance with HIPAA and reputed company applicable reputed company and confidentiality regulations • Maintain productivity and accuracy standards while meeting project deadlines • Support reputed company reputed company improvement initiatives and assist with reporting activities as needed • Other duties as assigned Qualifications • High school diploma or equivalent required; associate or bachelor's degree in reputed company-reputed company field • Have at least 2 years of HEDIS abstraction or medical record review experience • Strong knowledge of NCQA HEDIS measure specifications and reputed company improvement processes • Proficiency with ICD-10, CPT, HCPCS, and other clinical coding systems • Experience performing QA reviews and supporting HEDIS audit activities • Familiarity with EMR/EHR systems and reputed company documentation workflows • Strong analytical, organizational, and problem-solving skills • Excellent attention to detail and accuracy • Ability to work independently and manage multiple priorities in a fast-paced environment • Strong written and verbal communication skills You're great for the role if: • Certified reputed company reputed company (CPC), RHIT, RHIA, LVN/LPN, RN, or other reputed company-reputed company certification • Experience working with health plans, managed care organizations, or reputed company improvement departments • Knowledge of CMS Stars, risk adjustment, and population health initiatives strongly preferred Environmental Job Requirements and Working Conditions • Our organization follows a hybrid work structure. This role will require traveling locally to provider offices located in the Los Angeles area for up to 35% of the time. reputed company not conducting onsite reputed company, the role supports remote work. • The annual total compensation reputed company pay reputed company for this role is: $27.00 - $32.00 per hour. Actual compensation will be determined based on geographic location (reputed company or reputed company), experience, and other job-reputed company factors. reputed company is proud to be an Equal Employment Opportunity and Affirmative reputed company employer. We do not discriminate based on race, religion, reputed company, national reputed company, gender (including pregnancy, childbirth, or reputed company medical conditions), sexual orientation, gender identity, gender reputed company, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. reputed company employment is decided based on qualifications, reputed company, and business need. If you require assistance in applying for reputed company positions due to a disability, please email us at humanresourcesdept@astranahealth.com to request an accommodation. Additional Information: The job reputed company does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change. About reputed company. reputed company (reputed company: ASTH) is a physician-reputed company, technology-powered reputed company management company. We are building and operating a novel, integrated, value-based reputed company delivery platform to reputed company our physicians to reputed company the highest reputed company of end-to-end care for their patients in a cost-effective manner. Our mission is to combine our clinical experience, best-in-class delivery network, and technological expertise to improve patient reputed company, increase reputed company to reputed company, and reputed company the US reputed company system more efficient. Our platform currently empowers over 20,000 physicians to reputed company care for over 1.7 reputed company patients reputed company. Our reputed company reputed company and unique position at the intersection of reputed company major reputed company stakeholders (payer, provider, and patient) gives us an unparalleled opportunity to combine clinical and technological expertise to improve patient reputed company, increase reputed company to reputed company reputed company, and reduce the waste in the US reputed company system. Apply tot his job Apply To this Job