LanceSoft, Inc. ยท 1 day ago
HEDIS Data Reviewer
Philadelphia, PA
Full-time
Hybrid
Mid Level
3+ years expLanceSoft, Inc. is seeking a HEDIS Data Reviewer to join their team. The role involves performing medical record abstraction and overread to support quality reporting for HEDIS and State EQRO, along with coordinating medical records identification and collection activities.
Information Technology
Hiring Manager
Palak Y.
Responsibilities
Coordination of the medical records identification process, collection activities and review
Performing and applying structured auditing abstraction criteria to medical records to determine compliance
Utilizing various software applications to support department operations and accurately entering the results of chart audits into the database
Developing and maintaining expertise in the requirements and parameters of mandated HEDIS and State performance measures
Completing medical record review abstraction and overread and providing feedback for medical records that do not meet the HEDIS or State Measure Technical Specifications criteria within a live software environment
Providing clinical and administrative support to providers as directed
Maintaining productivity level of a minimum of chases/charts per defined period according to policy
Maintaining an abstraction proficiency rate of 98% by correctly reading, interpreting, and abstracting various components of the medical record such as notes, consultations, medication forms, treatment plans, health history, interval history, and past history
Assisting in the medical record collection process including making phone calls, sending out faxes/letters or chart retrieval requests to providers as assigned
Completing additional designated projects assigned and deemed as necessary
Qualification
Required
Three to five years working with HEDIS data including chart review/collection
HEDIS, QRS, or STARs experience
Knowledge of medical terminology and basic charting to include diabetic labs, HPV testing, preventive health screenings, immunization and well-care terminology for children, adults and pregnant women
Understanding of current HEDIS Technical Specifications
Knowledgeable in the HEDIS audit process (PSV, CSV and MRRV)
Proficiency in Excel, Word, Power Point and Outlook
Experience with medical record abstraction tool(s) and willingness to learn any medical record abstraction tool
Experience in the Pediatric, Maternity, Diabetic or Provider Office Setting
Strong written and oral communication skills
Critical thinking skills
Strong organizational skills
Able to think and work independently, effectively, and under pressure of deadlines
Preferred
Familiar with the Cancer Registry
Familiar with Bright Futures
Company
LanceSoft, Inc.
Established in 2000, LanceSoft is a pioneer in delivering top-notch Global Workforce Solutions and IT Services to a diverse clientele.
5001-10000 employees
H1B Sponsorship
LanceSoft, Inc. has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (55)
2024 (32)
2023 (23)
2022 (25)
2021 (60)
2020 (80)
Funding
Current Stage
Late StageLeadership Team
Ram Karuppusamy
Chairman & CEO
Simon Dealy
Chief Financial Officer
Company data provided by crunchbase