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Job Description

Judge Healthcare is hiring HEDIS Nurses for an excellent contract assignment with a large Healthcare Company.This position is responsible for on-site HEDIS chart abstraction.
The medical record reviewer is responsible for ongoing medical chart data collection from provider offices/medical facilities and abstraction/data entry from the medical records. This includes traveling to provider offices/medical facilities to conduct on-site medical record review and data entering the findings into HEDIS Chart Review Portal.

Duties and Responsibilities:
Participate in HEDIS Measure Specific training and pass the associated tests at a 95% or higher accuracy.
Perform accurate and comprehensive medical record reviews. Must maintain a 95% or higher abstraction accuracy.
Participate in scheduled HEDIS meetings as indicated.
Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
Work closely with the chart retrieval team to coordinate the scheduling of provider offices/medical facilities for the onsite medical record review appointments.
Communicate effectively and professionally with providers and their office staff.
Performs on-site medical record reviews at provider offices/medical facilities.
Review/abstract electronic and paper charts to obtain specific information related to the hybrid HEDIS measures per NCQA technical specifications.
Data enter all findings into the HEDIS Chart Review Portal.
Scanning/copying documentation from the chart related to the specific information which supports all data findings entered into the HEDIS Chart Review Portal.
Ensure all information is collected in a safe, organized and confidential manner.
Ability to adapt to changing work environment and be flexible regarding work locations.
Ability to perform in a fast-paced environment.

Required Qualifications:
  • RN preferred, certified coders with appropriate HEDIS chart abstraction experience will be considered.
  • Strong knowledge base of HEDIS technical specifications and NCQA.
  • 1+ years HEDIS abstraction/data collection experience.
  • Previous on-site abstraction experience.
  • Previous managed care/quality improvement experience.
  • Strong data entry skills and computer navigation skills.
  • Ability to learn new information systems and software programs.
  • Ability to work independently.
  • Travel will be required for this position in and out of state.
  • Flexibility in work hours and location.

Job Requirements


Job Snapshot

Employment Type Full-Time
Job Type Health Care, Nurse
Education Not Specified
Experience Not Specified
Manages Others Not Specified
Industry Other Great Industries
Required Travel Not Specified
Job ID 399405
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