HEDIS Data Reviewer

Location: Philadelphia, PA 19113. Hybrid - 3 days Onsite

Duration: 3 months

Shift timing: 8 am -5:30 pm EST, Monday – Friday, some weekend work may be required.

Description:

Under the direction of the Manager of Medical Record Review Operations, the HEDIS Data Reviewer is responsible for performing medical record abstraction and overread in support of Quality reporting (annual Healthcare Effectiveness Data and Information Set (HEDIS) and State EQRO) with duties including but not limited to the following:

• Coordination of the medical records identification process, collection activities and review.

• Performing and applying structured auditing abstraction criteria to medical records to determine compliance.

• Utilizing various software applications to support department operations and accurately entering the results of chart audits into the database.

• Developing and maintaining expertise in the requirements and parameters of mandated HEDIS and State performance measures.

• Completing medical record review abstraction and overread and providing feedback for medical records that do not meet the HEDIS or State Measure Technical Specifications criteria within a live software environment.

• Providing clinical and administrative support to providers as directed.

• Maintaining productivity level of a minimum of chases/charts per defined period according to policy.

• Maintaining an abstraction proficiency rate of 98% by correctly reading, interpreting, and abstracting various components of the medical record such as notes, consultations, medication forms, treatment plans, health history, interval history, and past history.

• Assisting in the medical record collection process including making phone calls, sending out faxes/letters or chart retrieval requests to providers as assigned.

• Completing additional designated projects assigned and deemed as necessary. "

Skills:

• Three to five years working with HEDIS data including chart review/collection. HEDIS, QRS, or STARs experience. Knowledge of medical terminology and basic charting to include diabetic labs, HPV testing, preventive health screenings, immunization and well-care terminology for children, adults and pregnant women.

• Understanding of current HEDIS Technical Specifications.

• Knowledgeable in the HEDIS audit process (PSV, CSV and MRRV).

• Proficiency in Excel, Word, Power Point and Outlook.

• Experience with medical record abstraction tool(s) and wiliness to learn any medical record abstraction tool.

• Experience in the Pediatric, Maternity, Diabetic or Provider Office Setting.

• Familiar with the Cancer Registry.

• Familiar with Bright Futures.

• Strong written and oral communication skills, critical thinking skills, strong organizational skills.

• Able to think and work independently, effectively, and under pressure of deadlines. "

Education:

Associates Degree, RN, LPN, or relevant work experience.

About our Company: -

22nd Century Technologies, Inc., is one of the fastest growing IT Service Integrator and Workforce Solution companies in the United States. Founded in 1997, 22nd Century Technologies is a Certified National Minority Business Enterprise with 6,000 people including 600 Cyber SMEs nationwide supporting our customers in all 50 states, Canada, and Mexico. With HQs in Somerset, NJ and Mclean, VA, 22nd Century has 14 offices throughout the United States. As part of our unrelenting focus on quality and compliance, 22nd Century Technologies’ delivery is based on Certified Matured Processes including CMMI L3 Dev & SVC, ISO 20000, ISO 27001, and ISO 9001 quality processes. With a strong focus on the public sector, 22nd Century currently holds government contracts with 14 out of 15 Federal Executive agencies including DoD, 37 other Federal agencies, 50 States, 115 Local agencies, and 37 School Districts. In the last three years, we have expanded our services to Fortune 500 and other commercial clients and currently support 80 commercial clients.

Recognized among “Best Company to Work For” by Forbes, 22nd Century Technologies, Inc., consistently exceeds our clients’ expectations by focusing on their absolute satisfaction with jobs while keeping our employees motivated.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

LI_TSC

Job Types: Full-time, Contract

Pay: $30.00 - $40.00 per hour

Expected hours: 40 per week

Ability to Commute:

• Philadelphia, PA 19113 (Required)

Ability to Relocate:

• Philadelphia, PA 19113: Relocate before starting work (Required)

Work Location: In person

Salary : $30 - $40