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HEDIS Reviewer

Work from home Full-time role Hiring

About the position The HEDIS Reviewer II position involves the collection and review of medical records to abstract clinical information for HEDIS quality reporting. The role requires interpreting clinical criteria, annotating records, and ensuring compliance with HEDIS and CMS performance measures. Training will be provided prior to the start of the assignment, and the position is fully remote, requiring proficiency in computer-based tasks.

Responsibilities

  • Complete assigned abstraction and data entry each day.

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  • Work with provider offices to schedule/confirm appointments and follow up on medical record submissions.

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  • Locate and review all assigned medical charts, perform abstraction, and copy supporting documentation as specified.

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  • Data enter all assigned abstracts into the applicable software system.

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  • Prioritize and accurately complete tasks within established times.

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  • Identify trends and document areas for improvement.

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  • Maintain project productivity levels while ensuring accuracy in abstraction and data entry activities.

Requirements

  • 0-3 years of experience auditing and abstracting medical records required.

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  • Medical knowledge/terminology is required.

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  • Ability to read and interpret medical records.

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  • Proficient in Microsoft Word, Excel, email, and Adobe Reader.

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  • Excellent verbal and written communication skills.

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  • Exceptional attention to detail and strong analytical skills.

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  • Proven organizational and time management skills.

Nice-to-haves

  • Experience with HEDIS quality reporting is a plus.

Benefits

  • Fully remote work environment.

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  • Equal opportunity employer with a commitment to diversity and inclusion.

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