HEDIS Medicaid

Clinical experience and will work under the supervision of the HEDIS Coordinator. They are a member of the medical record review team. The team is responsible for obtaining and performing accurate comprehensive reviews of medical records in support of The HEDIS Effectiveness Data and Information Set project. HEDIS reviews are completed in accordance with NCQA guidelines and technical specifications.

LPN is preferred but mainly need someone with EMR experience

JOB REQUIREMENTS:
Knowledge of medical terminology
Data entry and/or typing experience.
Clear and concise written and verbal communication skills.
PC proficiency to include Word, Excel and Lotus Notes.
Customer service skills
Auditing experience preferred.

DUTIES AND RESPONSIBILITIES:
Comply with appropriate procedures for scheduling, requesting, and reviewing records on-site at physician offices, hospitals and other health care facilities.
Initiates Fax Cover Page and Provider letter documenting medical record request.
Schedules and record onsite appointment in share calendar with team lead.
Locate and review all assigned medical charts, copy all supporting documentation per specifications and data enter into the applicable software system ALL assigned abstracts.
Utilizes various software applications to support HEDIS operations by entering data and / changing chase status pertaining for the identified chase(s).
Maintains compliance with all HIPAA and patient confidentiality requirements.
Participate in medical record abstraction and inter-rater reliability process as needed.
Maintains a less than 5% error rate in record abstraction and data entry.
Meets with HEDIS Coordinator and / or QI Specialists to discuss HEDIS efforts, any open issues and can include IRR results.
All other duties as assigned.

Notes:
Fully remote in IL