HEDIS Reviewer II

Job Title: HEDIS Reviewer II
Duration: 4+ Months
Location: Clayton, MO 63117
Position Summary:
Participates in the review of medical records to abstract clinical information for HEDIS reporting. May require travel to physician offices; Nursing license preferred but not required. Successful HEDIS review experience may be substituted for licensure
Duties:
• Work with provider offices as needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters
• Locate and review ALL assigned medical charts, perform abstraction, copy all supporting documentation per specifications and data enter into the applicable software system ALL assigned abstracts.
• Prioritize and accurately complete tasks within established times
• Identifying trends and documentation of areas for improvement
• Maintaining project productivity levels while maintaining accuracy requirements for abstraction and data entry activities
• Handle incoming calls from providers and voicemails
• Rerouting Return Mail
• Additional tasks as assigned
*This position has a small chance of needing to go onsite to a provider’s office to collect needed medical records, aProduct only if needed.
Experience:
• 1-3 seasons of experience auditing and abstracting medical records required
• Candidate must commit to attend all required training and conference calls assigned for the project.
• Candidate must return all equipment that is supplied to them in good working condition and in a timely manner at the end of the project
• Medical knowledge/terminology is required.
• Ability to read and interpret medical records.
• Professional demeanor and good work ethic.
• Computer savvy: Microsoft Word, Excel, email, and Adobe reader required. Know how to save a file to a folder.
• Excellent verbal and written communication skills – clear, concise and appropriate.
• Conscientious problem solver, willing to learn, and take personal pride in their work performance/accuracy.
• Exceptional attention to detail and excellent analytical, investigation, and problem-solving skills
• Proven organizational and time management skills including the ability to meet required deadlines
• Must keep all information collected in a safe, organized and confidential manner while maintaining confidentiality of PHI, HIPAA Privacy and Security Rules.