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LanceSoft, Inc. · 1 day ago

HEDIS Data Reviewer

Philadelphia, PA

Contract

Onsite

New Grad, Entry Level

LanceSoft, Inc. is seeking a HEDIS Data Reviewer to support Quality reporting through medical record abstraction and overread. The role involves coordinating medical record activities, applying auditing criteria, and providing clinical support while maintaining high productivity and accuracy standards.

Information Technology

Growth Opportunities

H1B Sponsor Likely

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

Medical record abstractionHEDIS knowledgeData entryAuditing criteria applicationClinical supportAdministrative supportCommunication skills

Required