HEDIS Reviewer III

• This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS and CMS performance measures.
• Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements.
• Participates in the collection and review of medical records to abstract clinical information for Hedis quality reporting.
• Complete assigned abstraction and data entry each day.
• Work with provider offices as needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters.
• Locate and review ALL assigned medical charts, perform abstraction, copy all supporting documentation per specifications and data enter into the applicable software system ALL assigned abstracts.
• Prioritize and accurately complete tasks within established times.
• Identifying trends and documentation of areas for improvement.
• Maintaining project productivity levels while maintaining accuracy requirements for abstraction and data entry activities.

Last updated on Oct 19, 2023