Highlights
Additional tasks involve helping with EMR Medical Record Retrieval for HEDIS, contacting provider offices to request or validate facility and provider contact information and record retrieval preference, and/or requesting medical records for the HEDIS project and supporting other needs within the Quality Department. The main duties include chart retrieval, using proprietary tools and software to conduct thorough medical record reviews in line with NCQA specifications, retrieval follow-up, and escalating issues as needed.
Numbers & Facts
| Location | Columbia, MD |
| Industry | Staffing/Employment Agencies |
| Salary | $40–$41.45 Per Hour |
| Company Size | 500 to 999 employees |
| Website | http://www.ampcus.com |
Description
Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team.
Job Title: Health Services - Nurse, Clinical Medical Review
Location(s): MD, DC, VA, PA, or DE
Job Summary:
The Clinical Medical Review Specialist (a professional with clinical experience) will report to the Clinical Support Supervisor – HEDIS and be part of the Quality Team. The main duties include chart retrieval, using proprietary tools and software to conduct thorough medical record reviews in line with NCQA specifications, retrieval follow-up, and escalating issues as needed. Main duties will be assigned according to experience, knowledge, skills, and abilities. This role requires extensive knowledge of HEDIS measures to accurately and expediently abstract medical records, all while adhering to HIPAA Privacy and Security standards. Additional tasks involve helping with EMR Medical Record Retrieval for HEDIS, contacting provider offices to request or validate facility and provider contact information and record retrieval preference, and/or requesting medical records for the HEDIS project and supporting other needs within the Quality Department.
Key Responsibilities:
- Conduct thorough medical record reviews using proprietary tools and software.
- Ensure compliance with NCQA specifications and HIPAA Privacy and Security standards.
- Assist with EMR Medical Record Retrieval for HEDIS.
- Contact provider offices for facility and provider contact information and record retrieval preferences.
- Support other needs within the Quality Department as required.
Required Qualifications:
- Bachelor’s degree in Nursing, Associate’s degree in Nursing, or Diploma in Nursing, or 10 years of relevant HEDIS abstraction and/or overread experience.
- 3 years of clinical experience and 5 years of HEDIS experience.
- Proficiency with Microsoft Office, including Excel, Word, PowerPoint, Microsoft Teams, and Outlook.
- Experience retrieving medical records from EMR platforms such as Epic, eClinicalWorks, Athena, Cerner, Allscripts, and Tebra.
Benefits Overview:
- Health & Wellness: Comprehensive pre-tax health, dental, and vision insurance options.
- Life Insurance: Group term life insurance and voluntary life insurance coverage.
- Retirement Savings: 401(k) retirement savings plan to help you plan for your future.
Ampcus is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veterans or individuals with disabilities.
About Company
Ampcus Inc is a global technology and business consulting firm specializing in Digital Transforrmation, Big Data, Analytics, Cyber Security, Testing, IV&V, Infrastructure Management and Enterprise Solutions. Ampcus Inc is an SBA 8(a) certified Women and Minority Owned global Provider of broad range of consulting Services. From strategy to execution, our disciplined yet flexible approach starts and ends with our clients. By listening hard and working harder, their goals become our goals. We are an ISO 9000, ISO 20000, ISO 27000 and CMMi Level certified company.
Ampcus consultants have significant business, engineering and technology experience. Our consultants have over 20 years of business experience and an average of over 10 years of engineering and technology experience. This means that the project teams understand how systems work and how the technology impacts the business processes of organizations.
We believe that success of an engagement is determined by strong project management, clear communication and mutual commitment working collaboratively. Our methodology begins by listening to the customer needs, then working with their teams to gain a clear understanding of the requirements, while providing a knowledge transfer of best practices for the organization. As a recognized leader providing customized software services, management and engineering solutions to companies around the world, our ability to deliver is a "granted" that makes companies put their trust in us to answer their day-to-day business challenges and put them on a path for greater success. We are the choice for our clients because we look at our clients business from a growth perspective.
Industry: Information Technology and Services
Specialties: Digital Transformation, Big Data and Analytics, Infrastructure Management Services, Testing and IV&V, Cyber Security, Active Directory and E-mail Infrastructure, Project Management, Training, and ERP, CRM. EAI, BI