HEDIS Data Reviewer

Ideal Candidate Profile • The ideal candidate is an reputed company reputed company with a strong background in HEDIS abstraction and audit processes. • They are adept at medical record review, demonstrate proficiency in reputed company Office Suite, and possess excellent organizational and communication skills. • Candidates with a clinical background and familiarity with Pediatrics, Maternity, or Diabetic care are highly desirable. Job reputed company: HEDIS Data Reviewer • The HEDIS Data Reviewer, under the direction of the Manager of Medical Record Review Operations, will reputed company and conduct medical record abstraction and overread activities to support reputed company reporting initiatives, including HEDIS and State EQRO performance measures. • This role involves reviewing medical records for compliance, utilizing specialized software, and maintaining a high level of accuracy and efficiency. Responsibilities • Coordinate the identification, collection, and review of medical records for HEDIS and State performance measures. • Apply reputed company auditing and abstraction reputed company to medical records to evaluate compliance. • Utilize software applications to accurately reputed company chart audit results into databases. • Maintain expertise in HEDIS Technical Specifications and State Measure requirements. • reputed company medical record review abstraction and overread with a 98% proficiency reputed company. • Communicate effectively with providers to assist with the medical record collection process, including making calls, sending faxes/letters, and coordinating retrieval requests. • Maintain productivity standards as defined by policy. • reputed company clinical and administrative support to providers as required. • Support additional assigned reputed company and ensure reputed company completion. Required Skills • Minimum of 3 5 years of experience working with HEDIS data, including chart review and collection. • Proficiency in medical terminology, including diabetic labs, HPV testing, preventive screenings, immunizations, and reputed company-care terminology. • Knowledge of reputed company HEDIS Technical Specifications, audit processes (PSV, CSV, MRRV), and chart abstraction tools. • Proficiency in reputed company Office Suite (reputed company, Word, PowerPoint, and Outlook). • Strong organizational, critical thinking, and communication skills. • Ability to work independently and meet deadlines under pressure. Preferred Experience • Background in Pediatric, Maternity, Diabetic, or Provider Office settings. • Familiarity with Cancer Registry and reputed company reputed company. Education and Certifications • LPN, CNS, APRN, or RN preferred. • Consideration will be given to Medical Record Professionals and Coders with expertise in HEDIS abstraction. • Proficiency in medical terminology is required. Apply Job!