What are the responsibilities and job description for the Medical Records Reviewer position at VNS Health?
OverviewProvides ongoing HEDIS/QARR medical record collection and abstraction, as well as the collection of records related to Quality Management initiatives. Responsible for clinical audits needed across products. Provides accurate assessment of provider performance against HEDIS/QARR standards and procedures. Adheres to HIPAA confidentiality requirements for protected health information. Works under general supervision.
What We Provide
- Referral bonus opportunities
- Generous paid time off (PTO), starting at20daysof paid time offand 9 company holidays
- Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life andDisability
- Employer-matched retirement saving funds
- Personal and financial wellness programs
- Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
- Generous tuition reimbursement for qualifying degrees
- Opportunities for professional growth and career advancement
- Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
- Interdisciplinary network of colleagues through the VNS Health Social Services Community ofProfessionals.
What You Will Do
- Interacts directly with provider offices, clinics, and other healthcare facilities on the retrieval of medical records for review and abstraction pertaining to HEDIS/QARR and other focused audits/studies. Provides guidance on protocol as required.
- Schedules and performs onsite medical record reviews with high volume providers for compliance with HEDIS/QARR standards. Evaluates documentation discrepancies identified during initial review and advises on corrective actions as appropriate. Reviews and enters documentation findings into a database.
- Manages and organizes scanned medical records in a central repository inclusive of performing data entry, scanning relevant components of the medical record to support reviews performed, and using appropriate naming convention.
- Safeguards confidentiality of the medical charts/records and complies with all local, state, and federal laws pertaining to medical records. Assures compliance with all HIPAA regulations concerning use, retrieval, storage, and sharing of medical records.
- Educates providers and office staff on HEDIS/QARR quality metrics, specifications, and medical record review criteria.
- Participates in required trainings. Participates and assist in quality improvement audits, surveys and focused studies.
- Maintains a comprehensive understanding of the QM policies and procedures and ensure compliance.
- Abstracts medical data from medical records assigned to consultant in a precise and proficient manner
- Accesses scanned copies of medical records in appointed vendor tool or from Client's VPN directory
- Abstracts data, annotate medical records and enter information into the appointed vendor data collection tool per HEDIS MY 2024 specifications.
- Follows up on all outstanding issues found during medical record review. This includes initiation and completion of chart issues
- Accesses EMR's to get pertinent information
- Participates in special projects and performs other duties as assigned.
Education:
- Associate's Degree in Nursing, Health Care Administration, Registered Health Information Technician (RHIT), Registered Health Information Administrator (RHIA), Certified Coder, Allied Health professional or other health related field required
Work Experience:
- Minimum two year experience in medical record retrieval and review required
- Minimum of one year quality improvement experience in Medicare, Medicaid or Commercial Health Plan Knowledge of HEDIS/QARR standards, medical terminology, strong computer and organizational skills required
- Ability to evaluate medical records with attention to detail required
- Ability to use databases and prepare reports as needed required
- Ability to multitask and troubleshoot problems independently. required
- Effective oral and written communication and interpersonal skills required
- Proficient in personal computer, preferably Microsoft Windows Word, PowerPoint, Excel and Access required
VNSNY is an equal opportunity employer M/F/D/V https://tbcdn.talentbrew.com/company/1238/v1_0/img/eeopost.original.pdf
Salary : $28 - $35
