Elevait Solutions · 2 days ago
HEDIS Data Reviewer
Philadelphia, PA
Contract
Onsite
Mid Level
$40/hr - $42/hr
3+ years expElevait Solutions is seeking a HEDIS Data Reviewer to support HEDIS and State EQRO quality reporting through accurate medical record abstraction, auditing, and chart review. The role requires strong knowledge of HEDIS technical specifications and involves responsibilities such as performing medical record abstraction and applying structured auditing criteria to assess compliance with quality measures.
ConsultingHuman ResourcesRecruitingStaffing Agency
Hiring Manager
Roshni Siddiqui
Responsibilities
Perform medical record abstraction and over-reads to support HEDIS and State EQRO quality reporting
Apply structured auditing criteria to assess compliance with HEDIS and State performance measures
Accurately enter chart audit results into designated abstraction and reporting systems
Maintain up-to-date knowledge of HEDIS and State technical specifications and reporting requirements
Provide feedback on medical records that do not meet HEDIS or State criteria
Assist with medical record collection, including provider outreach via phone, fax, and written requests
Qualification
Required
HEDIS medical record abstraction
Quality measure compliance and auditing
Medical terminology and chart review
Strong understanding of current HEDIS Technical Specifications
Knowledge of HEDIS audit processes (PSV, CSV, MRRV)
Ability to interpret and abstract clinical documentation accurately
Proficiency with medical record abstraction tools
Proficiency in Microsoft Excel, Word, PowerPoint, and Outlook
Strong written and verbal communication skills
Ability to work independently and meet productivity and accuracy benchmarks
3–5 years of experience in HEDIS data, chart review, and medical record abstraction
Experience abstracting preventive screenings, immunizations, diabetic labs, HPV testing, maternity, and pediatric care
Ability to maintain defined productivity standards
Ability to achieve and sustain a 98% abstraction accuracy rate
Ability to work under deadlines and pressure while maintaining quality standards
Associate's degree, RN, LPN, or equivalent relevant work experience
Preferred
Experience with QRS or STARs quality programs
Background in pediatric, maternity, diabetic, or provider office settings
Familiarity with Cancer Registry
Familiarity with Bright Futures guidelines
Experience supporting providers clinically or administratively
Company
Elevait Solutions
Elevait Solutions offers consulting and workforce solutions using proprietary machine-learning technology.
201-500 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase