HEDIS Abstractor

Medica Talent Group

420d • $47,840 - $56,160 • Remote

About The Position

The HEDIS Abstractor position at Medica Talent Group is a full-time remote role focused on the review and abstraction of medical records to ensure compliance with HEDIS standards. The role involves data entry, collaboration with quality care coordinators, and adherence to NCQA guidelines, with an emphasis on maintaining productivity standards and ensuring the privacy of protected health information.

Requirements

• Bachelor's Degree or equivalent experience in healthcare preferred.
• Minimum of three years of experience in healthcare, with at least two years in coding and medical record abstraction.
• One year of managed care experience preferred.
• Valid RN or LVN license preferred.
• Knowledge of NCQA guidelines, HEDIS Technical Specifications, and HEDIS Measure Detail.

Nice To Haves

• Spanish language proficiency preferred.
• Certified Coding Specialist certification preferred.

Responsibilities

• Coordinate and prepare the HEDIS medical record review project, including ongoing medical records review and auditing.
• Accurately enter 95% of data into abstraction tools and/or ICE files.
• Collaborate with Quality Care Coordinators on Stars/HEDIS related activities and medical record retrieval.
• Ensure compliance with HIPAA regarding the privacy and security of Protected Health Information (PHI).
• Read and adhere to NCQA HEDIS Technical Specifications and annual updates.
• Communicate changes and maintain HEDIS training materials.
• Assist in training and lead training activities using standardized materials.
• Report challenges or technical issues to supervisors and ensure deadlines are met.
• Maintain the Stars/HEDIS Calendar events and complete assigned tasks on time.
• Visit provider offices for in-person training on HEDIS measures and abstraction processes.
• Monitor accuracy of abstracted records as required by NCQA specifications.

Benefits

• Health insurance
• Dental insurance
• 401(k)
• Paid time off
• Vision insurance

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Bachelor's degree