HEDIS Reviewer II

HEDIS

This posting will have some pre-ID candidates, and we will hire the remaining from sourced candidates. You are able to submit candidates for this posting.
Participates in the collection and review of medical records to abstract clinical information for HEDIS quality reporting.  Training will be provided prior to the start of the assignment.
This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS and CMS performance measures.  Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements.  The candidate must be proficient with databases and with conducting 100% of work activities on the computer.
Must commit to duration of the project with the understanding that work hours can be varied. Due to proprietary information, must inform employer if they are planning to accept employment with another company.
Please have the candidates fill out this brief questionnaire and return with resumes:
REMINDER: Please have the temp candidate take a drug test as soon as the 30 day window hits.

QUESTIONNAIRE FOR TOP OF RESUME
Is the name listed on your resumes your legal name and spelt correctly, if not please provide that name
What is your current address (including the Apartment unit # and info if applicable) Suppliers make sure this matches in Fieldglass
Do you have an alternate phone number to what is already on your resume
Are you able to work Monday thru Friday, 8 am to 5 pm your local time (January thru May) without interruption
Do you have anything that requires time off or would prevent you from working the above required schedule (January thru May)
Please list 3 different Microsoft Office Suite Programs you have experience with and how many years you\'ve worked in each one.
Are you able to connect the Aetna provided laptop to your home internet modem via an ethernet cable connection (Not thru a WiFi connections)
Do you have the reliable transportation to travel to a provider\'s office, if needed
Are you able to carry equipment that weigh up to 20lbs

Duties
Work with provider offices as needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters
Locate and review ALL assigned medical charts, perform abstraction, copy all supporting documentation per specifications and data enter into the applicable software system ALL assigned abstracts.
Prioritize and accurately complete tasks within established times
Identifying trends and documentation of areas for improvement
Maintaining project productivity levels while maintaining accuracy requirements for abstraction and data entry activities
Handle incoming calls from providers and voicemails
Rerouting Return Mail
Additional tasks as assigned
This position has a small chance of needing to go onsite to a provider\'s office to collect needed medical records, again only if needed.

Experience
1-3 seasons of experience auditing and abstracting medical records required
Candidate must commit to attend all required training and conference calls assigned for the project.
Candidate must return all equipment that is supplied to them in good working condition and in a timely manner at the end of the project
Medical knowledge/terminology is required.
Ability to read and interpret medical records.
Professional demeanor and good work ethic.
Computer savvy: Microsoft Word, Excel, email, and Adobe reader required. Know how to save a file to a folder.
Excellent verbal and written communication skills clear, concise and appropriate.
Conscientious problem solver, willing to learn, and take personal pride in their work performance/accuracy.
Exceptional attention to detail and excellent analytical, investigation, and problem-solving skills
Proven organizational and time management skills including the ability to meet required deadlines
Must keep all information collected in a safe, organized and confidential manner while maintaining confidentiality of PHI, HIPAA Privacy and Security Rules

Position Summary
Participates in the review of medical records to abstract clinical information for HEDIS reporting. May require travel to physician offices; Nursing license preferred but not required. Successful HEDIS review experience may be substituted for licensure

Education
N/A

What days & hours will the person work in this position List training hours, if different.
Mon-Fri, 8 hours worked, between 8am-5pm local time