HEDIS Medical Record Abstractor (Nursing Fresh Grads l RN)

Job Title: HEDIS Medical Record Abstractor (Nursing Fresh Grads l RN)

Job Type: Permanent

Job Mode: Remote support

ESSENTIAL DUTIES & RESPONSIBILITIES

• Identifying and communicating patterns of missing documentation for the assessment of additional records
• Routing all exclusions and complex issues to the Quality Improvement Nurse
• Meeting or exceeding accuracy standard of 95% and turn around standard of 24-48 hours for medical record review and data entry
• Attending department meetings and delivering hard copy records weekly
• Successfully completing HEDIS software training and using software correctly to facilitate accurate reporting and ongoing progress of the annual HEDIS project
• Conducting research in a thoughtful and methodical search in order to locate specific claim information, including all resources provided in order to find best information
• Review and abstract paper and electronic medical records utilizing NCQA HEDIS Technical specifications to optimize Plan HEDIS scores
• Perform complete and accurate data entry of qualifying services and results into HEDIS electronic database software
• Performs other duties as assigned.

QUALIFICATIONS

• Registered Nurse
• HEDIS trained or Minimum of 1 year experience in HEDIS coding.