Medical Record Reviewer - LPN

Capital Blue CrossHarrisburg, PA
Hybrid

About The Position

The position will complete review and abstraction of medical records utilized for annual HEDIS submission. The reviewer will be required to track data submission and inform management of any trends, barriers, or backlog. The position requires interpretation of clinical data submissions in order to accurately submit records for processing or return the records to the submitter in a timely manner with detailed return reasons. Other responsibilities may include medical record retrieval either onsite or via remote access throughout the year, participation in annual HEDIS hybrid record processes, involvement in Health Outcomes Improvement Team initiatives.

Requirements

  • Must have active Licensed Practical Nurse (LPN) license
  • 1-2 years of medical record review experience required
  • Knowledge of Facets, Excel and various software used for medical record abstraction documentation
  • Medical Terminology
  • Proficient in using electronic health records (EHR)
  • Ability to communicate effectively and professionally, both verbally and in writing with various audiences
  • Ability to plan, organize and coordinate multiple tasks and priorities
  • Ability to perform duties with minimal supervision
  • Includes the ability to act both independently and as part of a team while adapting to changing priorities
  • Analytical skills

Responsibilities

  • complete review and abstraction of medical records utilized for annual HEDIS submission
  • track data submission and inform management of any trends, barriers, or backlog
  • interpretation of clinical data submissions in order to accurately submit records for processing or return the records to the submitter in a timely manner with detailed return reasons
  • medical record retrieval either onsite or via remote access throughout the year
  • participation in annual HEDIS hybrid record processes
  • involvement in Health Outcomes Improvement Team initiatives
  • Review patient records to ensure documentation aligns with medical, legal, regulatory, and insurance standards
  • Abstract appropriate supporting documentation into abstraction tool
  • Support audits for internal quality control or external compliance (e.g., Medicare/Medicaid, insurance carriers)
  • Collaborate with healthcare providers or internal staff to clarify unclear or incomplete documentation

Benefits

  • Medical, Dental & Vision coverage
  • a Retirement Plan
  • generous time off including Paid Time Off, Holidays, and Volunteer time off
  • an Incentive Plan
  • Tuition Reimbursement

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What This Job Offers

Job Type

Full-time

Career Level

Entry Level

Education Level

Associate degree

Number of Employees

501-1,000 employees

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