HEDIS Data Reviewer

Job Description :

• Coordination of the medical records identification process, collection activities and review.
• Performing and applying structured auditing abstraction criteria to medical records to determine compliance.
• Utilizing various software applications to support department operations and accurately entering the results of chart audits into the database.
• Developing and maintaining expertise in the requirements and parameters of mandated HEDIS and State performance measures.
• Completing medical record review abstraction and overread and providing feedback for medical records that do not meet the HEDIS or State Measure Technical Specifications criteria within a live software environment.
• Providing clinical and administrative support to providers as directed.
• Maintaining productivity level of a minimum of chases / charts per defined period according to policy.
• Maintaining an abstraction proficiency rate of 98% by correctly reading, interpreting, and abstracting various components of the medical record such as notes, consultations, medication forms, treatment plans, health history, interval history, and past history.

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