Job Description

Duties

• Review and abstract relevant data from medical records and case management to ensure compliance with HEDIS measures, clinical information and treatment history
• Validate and verify the accuracy of abstracted data to ensure it meets quality standards and aligns with HEDIS specifications
• Work with Providers and clinical staff to obtain the necessary medical records
• Conduct quality checks on abstracted data to identify and resolve any errors or inconsistencies, ensuring high data integrity for reporting purposes
• Provide abstraction results, including trends and areas for improvement, to inform stakeholders and support quality improvement initiatives
• Stay up to date on HEDIS measure changes and healthcare regulations, continuously seeing ways to improve the abstraction and overread process
• Document findings in applicable HEDIS databases and on prescribed platforms.
• Meet daily medical record overview goals.
• Track and report on issues and outcomes as related to abstractions and over-reads.
• Correct errors identified through over-read process, including re-review of charts that may contain similar errors.
• Maintain productivity level as determined by QI department
• Maintain compliance with all HIPAA and Patient Confidentiality requirements

Skills:

• 1-3 years Demonstrated expertise, medical record and/or case management data collection, medical terminology
• Should have knowledge of HEDIS, medical terminology and basic charting.
• Ability to work in a production environment.
• The ability to function effectively within multidisciplinary teams.
• Ability to accurately complete tasks within established times.
• Ability to effectively prioritize multiple tasks and deadlines.

Education:

• High School/GED

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