VIVA USA Inc. ยท 8 hours ago
HEDIS Reviewer
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Insider Connection @VIVA USA Inc.
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Responsibilities
Participates in the review of member records for the abstraction and data entry of information to meet Performance Measures (HEDIS/CMS) quality reporting.
Locate and download appropriate documents from the case management system and interpret relevant measure criteria.
Annotate documentation via Adobe PDF and populate into a data collection tool to record compliance with HEDIS and CMS performance measure technical specifications.
Ensure all documentation of required information is accurate and complete.
Qualification
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Required
0-3 years of experience auditing and/or abstracting medical records required
Excellent skills using Adobe/PDF to include commenting/annotating are required
Excellent skills and working knowledge using Microsoft Word, Excel, Outlook, Explorer (creating, saving files to folders)
Ability to follow directions with minimum errors
Ability to read and interpret technical specifications, procedures
Communicate in a clear, concise, and appropriate manner to all levels of staff
Positive attitude, willingness to learn, and personal pride in work performance
Exceptional attention to detail and excellent analytical, investigation, and problem-solving skills
Excellent organizational and time management skills
Prioritize and accurately complete tasks within established timeframes
Verifiable High School Diploma or GED Required
Preferred
Previous experience entering data using Inovalon/QMRM (QSHR) a plus
Nursing license preferred but not required
Successful HEDIS review experience may be substituted for licensure