HEDIS Clinical Terminologist

A company is looking for a HEDIS Clinical Terminologist (Contract).

Key Responsibilities

Review EHR and PDFs of medical records to collect and validate HEDIS conformant data elements

Abstract and code clinical data from medical records in compliance with HEDIS and STARS standards

Participate in audits, quality assurance, and product improvement activities as needed

Required Qualifications

2+ years of recent HEDIS abstraction experience, including familiarity with STARS measures

Strong clinical acumen with the ability to translate clinical information into codified concepts (e.g., ICD10, HCPCS, CPT, SNOMED, LOINC)

Strong knowledge of NCQA HEDIS guidelines and CMS STARS specifications

Experience using HEDIS abstraction tools

Relevant certifications such as LPN, RN, or Medical Assistant