HEDIS Abstractor and Overreader jobs in United States
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agilon health · 11 hours ago

HEDIS Abstractor and Overreader

positionUnited States
timeFull-time
remoteRemote
seniorityEntry, Mid Level
money$24/hr - $28.70/hr
date2+ years exp

Agilon health is a healthcare company focused on improving health outcomes. They are seeking a HEDIS Abstractor and Overreader to review and abstract clinical data, ensuring compliance with HEDIS specifications and supporting quality reviews.

Health CareHospitalPrimary and Urgent Care

Responsibilities

Review and abstract clinical data from electronic medical records in alignment with HEDIS technical specifications
Perform overreads of abstracted medical records for accuracy, completeness and measure compliance
Demonstrate high level of proficiency in HEDIS measures and coding standards (including but not limited to ICD-10, CPT and CPTII) to close gaps in care
Collaborate with internal and external partners to resolve documentation discrepancies and provide recommendations for improvement
Support audit preparation and participate in internal quality reviews and training sessions
Manages all activities to meet health plan contractual and reporting timeframes
Identify trends in abstraction that may impact measure performance or audit readiness and proactively escalate to leadership
Other duties as assigned

Qualification

HEDIS measures proficiencyICD-10 codingCPT codingEMR platforms proficiencyMedicare Advantage familiarityQuality data integrationLanguage skillsExcel skillsAdobe skillsTeam playerAttention to detail

Required

Minimum of 2 years' experience working with NCQA HEDIS programs and/or HEDIS abstraction in all measures
Proficiency in EMR platforms (i.e., Epic, Cerner) and abstraction tools
Familiarity with Medicare Advantage lines of business and Stars Measures
Familiarity with supplemental data processes and quality data integration
High School Diploma or equivalent required
Ability to be a team player and exercise initiative in responding to team members or Sr. Manager
Thorough understanding of medical record documentation and medical terminology
High level of attention to detail and ability to follow direction on project deadlines
Ability to work independently
Strong language skills in English speaking and understanding
Ability to meet high productivity requirements and Interrater Reliability standards
Strong Excel skills
Ability to interpret compliance vs non-compliance on health plan gap file use to direct abstraction efforts
Ability to apply deep level of measure understanding to legal medical records
Strong Adobe skills (including saving records in PDF format and annotation)
Ability to interpret large data files for needed abstraction
Deep level of ability to recognize medical records that are not complete or are missing needed data points in overreading
Ability to report clearly on both positive or negative findings and apply possible solutions on Team calls

Company

agilon health

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Agilon Health partners with primary care physicians to define a new standard of quality, efficiency and patient experience.
dateFounded in 2016
location
Long Beach, California, USA
people-size501-1000 employees
web-link
https://www.agilonhealth.com/

Funding

Current Stage
Public Company
Total Funding
$1.87B
2023-05-15Post Ipo Secondary· $1.87B
2021-04-14IPO

Leadership Team

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Karthik Rao
Senior Medical Director
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Recent News

GlobeNewswire
agilon health, inc. Class Action: Levi & Korsinsky Reminds agilon health, inc. Investors of the Pending Class Action Lawsuit with a Lead Plaintiff Deadline of March 2, 2026 – AGL
2026-01-23
GlobeNewswire
AGL INVESTOR NOTICE: Faruqi & Faruqi, LLP Investigates Claims on Behalf of Investors of agilon health
2026-01-23
PR Newswire
agilon health, inc. (AGL) Shareholders Investors Who Lost Money Have Opportunity to Lead Securities Fraud Lawsuit
2026-01-23
Company data provided by crunchbase