HEDIS Reviewer II

Job Title:

HEDIS Reviewer II Address:
City, State

Job Description:

Participates in reviewing and abstracting medical records to support HEDIS quality reporting and CMS performance measures.

Locates and reviews assigned medical charts, abstracts clinical information, and copies supporting documentation. Uses software systems for data entry, ensuring accuracy and completeness of documentation. Coordinates with provider offices for appointment scheduling, record submissions, and follow-ups. Maintains productivity while adhering to accuracy standards in data abstraction and entry. Handles incoming calls and reroutes return mail as needed. Participates in training and may travel to provider offices for record collection.

Remote work with potential onsite visits to provider offices. Monday through Friday, 8:00 am - 5:00 pm local time.

Ability to connect to the internet via ethernet cable. Work involves handling equipment up to 20 lbs. Reliability in transportation for occasional travel. Work is primarily computer-based, involving databases, Adobe PDF, and Office Suite tools.

Compliance with confidentiality and security protocols for PHI and HIPAA.

High School Diploma or GED. Medical knowledge and terminology required. Experience in medical record auditing and abstraction (1-3 seasons). Proficiency in Microsoft Word, Excel, email, Adobe Reader. Excellent communication, organization, and attention to detail.