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HEDIS Clinical Quality Analyst - Abstractor and Overread

TotalMed Medfi
Carolina, SC Full Time
POSTED ON 11/21/2024 CLOSED ON 12/2/2024

What are the responsibilities and job description for the HEDIS Clinical Quality Analyst - Abstractor and Overread position at TotalMed Medfi?

This is a temporary position for the HEDIS season.

Responsibilities-

  • Performs provider/practitioner medical record reviews to verify clinical data elements for HEDIS® and HEDIS®-like measures abstracted by vendor, while meeting established production goals
  • Maintains HIPAA standards and confidentiality of protected health information; reports critical incidents immediately
  • Communicates questions and/or concerns to your Pod Manager or assigned Specialist, as appropriate, in a timely manner
  • Attends team meetings to provide information relating to clinical reviews and compliance
  • Successfully completes HEDIS® technical specification training and testing with a passing score of 95% or greater
  • Successfully completes HEDIS® software training and uses software correctly
  • Performs other duties as assigned

What does the ideal candidate background look like - HEDIS® experience with specific experience with any of the following BPD, CBP, COA, HBD, EED, CIS, DVSCH, IMA, LSC, TRC, and WCC. Overread experience of these measures. Healthcare and/or managed care industry experience.

Qualifications:

  • Three plus years HEDIS® / medical record review / MRRV experience
  • Three plus years healthcare / health plan industry experience
  • Detail-oriented, excellent proof-reading skills
  • Critical thinking skills
  • Excellent time management and prioritization skills
  • Effective communication skills
  • Strong proficiency with Microsoft Office applications, including: Word, Excel, Adobe, and PowerPoint
  • Results-driven independent worker and self-starter

#INDMLK

Job Type: Temporary

Pay: $30.00 - $40.00 per hour

Benefits:

  • Dental insurance
  • Health insurance
  • Vision insurance

Schedule:

  • 8 hour shift
  • Monday to Friday

Work Location: Remote

Salary : $30 - $40

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