HEDIS Reviewer II

Participates in the collection and review of medical records to abstract clinical information for HEDIS quality reporting. Training will be provided prior to the start of the assignment.

• 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, again only if needed.

• 1-3 seasons of experience auditing and abstracting medical records required
• 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.

• Verifyable High School Diploma or GED Required