HEDIS -Abstractor/Reviewer/MRR @ LanceSoft, Inc. | Jobright.ai
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LanceSoft, Inc. · 2 days ago

HEDIS -Abstractor/Reviewer/MRR

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Information Technology
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Hiring Manager
Nishit Shukla
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Responsibilities

Outreach to members to complete survey to address Social Determinants of Health (SDoH) barriers and provide helpful resources
Outreach to members and clinical providers to effectively coordinate care, obtain medical records and ensure patients receive preventive and chronic disease management services.
Search for relevant HEDIS records from databases, review medical records using HEDIS technical specification criteria or internal guidelines, and make annotations via Adobe PDF.
Ensure accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements.
Perform duties for additionally adhoc projects such as provider outreach to verify demographics and faxing providers.
Complete assigned abstraction and data entry each day.
Work with provider offices as needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters
Locate and review ALL assigned medical charts, perform abstraction, copy all supporting documentation per specifications and data enter into the applicable software system ALL assigned abstracts.
Prioritize and accurately complete tasks within established times
Identifying trends and documentation of areas for improvement
Maintaining project productivity levels while maintaining accuracy requirements for abstraction and data entry activities.

Qualification

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

HEDIS auditingMedical record abstractionMedical terminologyAdobe PDFMicrosoft WordMicrosoft ExcelConfidentiality PHIConfidentiality HIPAA

Required

3+ seasons of experience auditing and abstracting medical records required.
Candidate must commit to attend all required training and conference calls assigned for the project.
Candidate must return all equipment that is supplied to them in good working condition and in a timely manner at the end of the project.
Medical knowledge/terminology is required.
Ability to read and interpret medical records.
Professional demeanor and good work ethic.
Computer savvy: Microsoft Word, Excel, email, and Adobe reader required. Know how to save a file to a folder.
Excellent verbal and written communication skills – clear, concise and appropriate.
Conscientious problem solver, willing to learn, and take personal pride in their work performance/accuracy.
Exceptional attention to detail and excellent analytical, investigation, and problem-solving skills.
Proven organizational and time management skills including the ability to meet required deadlines.
Must keep all information collected in a safe, organized and confidential manner while maintaining confidentiality of PHI, HIPAA Privacy and Security Rules.

Preferred

Nursing license preferred but not required.
Successful HEDIS review experience may be substituted for licensure.

Benefits

Four options of medical Insurance
Dental and Vision Insurance
401k Contributions
Critical Illness Insurance
Voluntary Permanent Life Insurance
Accident Insurance
Other Employee Perks

Company

LanceSoft, Inc.

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Established in 2000, LanceSoft is a Certified MBE and Woman-Owned organization, and a pioneer in providing premium end-to-end Global Workforce Solutions and IT Services to diverse clients across various domains.

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
2023 (20)
2022 (22)
2021 (46)
2020 (69)

Funding

Current Stage
Late Stage

Leadership Team

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Ram Karuppusamy
Chairman & CEO
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Simon Dealy
Chief Financial Officer
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Company data provided by crunchbase
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