HEDIS Abstractor and Overreader

HEDIS Abstractor and Overreader page is loaded## HEDIS Abstractor and Overreaderlocations: Remote - USAtime type: Full timeposted on: Posted Yesterdayjob requisition id: R003486#

Company:

AHI agilon health, inc.# Job Posting Location:Remote - USA#

Job Title:

Support Specialist#

Job Description:

Candidates must be legally authorized to work in the United States without employer sponsorship, now or in the future.The HEDIS Abstractor and Overreader is responsible for the HEDIS Medical Record Review (MRR) process which includes accurately reviewing and abstracting medical records to determine compliance with HEDIS measure specifications, as well as conducting overreads to ensure data quality, consistency and adherence to NCQA guidelines. This role will work closely with internal and external stakeholders to ensure medical charts meet standards as outlined by HEDIS specifications and will partner with health plans to understand correct and consistent implementation of audit and testing processes for HEDIS measures.

Essential Job Functions:

• Review and abstract clinical data from electronic medical records in alignment with HEDIS technical specifications• Perform overreads of abstracted medical records for accuracy, completeness and measure compliance• Demonstrate high level of proficiency in HEDIS measures and coding standards (including but not limited to ICD-10, CPT and CPTII) to close gaps in care

• Collaborate with internal and external partners to resolve documentation discrepancies and provide recommendations for improvement• Support audit preparation and participate in internal quality reviews and training sessions• Manages all activities to meet health plan contractual and reporting timeframes
• Identify trends in abstraction that may impact measure performance or audit readiness and proactively escalate to leadership

Other Job Functions:

* Other duties as assigned.

Required Qualifications:

Minimum Experience

* Minimum of 2 years’ experience working with NCQA HEDIS programs and/or HEDIS abstraction in all measures* Proficiency in EMR platforms (i.e., Epic, Cerner) and abstraction tools* Familiarity with Medicare Advantage lines of business and Stars Measures* Familiarity with supplemental data processes and quality data integration

Education & Licensure

* High School Diploma or equivalent required

Skills and Abilities:

* Ability to be a team player and exercise initiative in responding to team members or Sr. Manager.* Thorough understanding of medical record documentation and medical terminology* High level of attention to detail and ability to follow direction on project deadlines* Ability to work independently* Strong language skills in English speaking and understanding* Ability to meet high productivity requirements and Interrater Reliability standards* Strong Excel skills* Ability to interpret compliance vs non-compliance on health plan gap file use to direct abstraction efforts.* Ability to apply deep level of measure understanding to legal medical records* Strong Adobe skills (including saving records in PDF format and annotation)* Ability to interpret large data files for needed abstraction* Deep level of ability to recognize medical records that are not complete or are missing needed data points in overreading* Ability to report clearly on both positive or negative findings and apply possible solutions on Team calls#

Location:

Remote - TX#

Pay Range:

$24.00 - $28.70Salary range shown is a guideline. Individual compensation packages can vary based on factors unique to each candidate, such as skill set, experience, and qualifications.# PASSION & PURPOSE## The passion to change the way healthcare is delivered permeates everyone and everything at agilon health. Working together we can use our expertise to make a difference in the lives of patients and physicians alike. We can bring the joy back to practicing medicine for physicians and improve the care experience for patients across the country.# PRIVACY & TRUST## We value your privacy and trust as much and are committed to protecting your personal information and respecting your choices. We use technology and best practices to ensure that your data is secure and compliant with applicable laws and regulations. We also provide you with clear and transparent information about how we collect, use, and share your data, and how you can access, update, or delete it. You can read our full privacy policy## Beware of recruitment scams - our company will never ask for payment or personal financial information during the hiring process; if you believe you've been contacted fraudulently, please reach out to our official recruiting team immediately at [email protected].# Equal Opportunity Employer## agilon health is committed to excellence through diversity. We are an equal opportunity employer and we will not discriminate against employees or qualified applicants for employment regardless of race; color; religion; genetic information; national origin; sex; pregnancy, childbirth, or related medical conditions; age; disability; citizenship status; uniform service member status; or any other protected class under federal, state, or local law.## We strive to develop leaders and build future talent pools to help us meet the needs of our customers. If you need assistance or an accommodation due to a disability, you may email us at [email protected]. #J-18808-Ljbffr Salary: USD 49920 - 59616 per year Experience: 2 years required