Job Description

About the job

Overview:

Our client, a provider of Health, Dental, Vision, Medicaid and Medicare Healthcare service plans in the state of California with 4.7 million members and $22.9 billion of annual revenues, seeks an accomplished HEDIS Medical Record Reviewer.

*** Candidate must be authorized to work in USA without requiring sponsorship ***

*** Candidate must be located in CA***

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• Job Title: HEDIS Medical Record Reviewer.
• Location: Remote (Long Beach, CA)
• Duration: 2+ months

IMPORTANT:

• Not looking for Zero HEDIS abstraction experience.
• Work Schedule: start between 8:30am – 4:30am (must be approved by Manager). Will work 8 consecutive hours from start time (not including breaks).
• 40 hours per week work.
• Candidate MUST have high-speed wired internet connection. Wi-Fi / Wireless connections are not allowed.
• Candidate MUST have a reliable home-office environment.

Description:

• This position will be in support of the HEDIS Medical Record Review (MRR) cycle.
• The individuals will work directly with HEDIS MRR Program Manager and other medical record reviewers to review medical record.
• Primary responsibility will be to perform medical record review & enter findings into abstraction tool (Inovalon QSHR) and to over read.
• Identify chase opportunities from the medical record.
• Coordinate with Program Manager, and administrative staff to manage caseload for teams.
• Communicate with team members to effectively manage project assignment.

Qualifications:

• Previous HEDIS Abstraction experience.
• Ability to maintain a high volume of abstractions.
• Must be proficient in computers and conduct most/all work activities on computer only.
• Required Testing: Post Interview Test – tests HEDIS measure proficiency.
• Software Skills Required: Microsoft Outlook, Excel, and Adobe experience.

Nice to haves:

• Previous overread experience.
• Ability to read and navigate clinical medical records in looking for specifically sought information.

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