What are the responsibilities and job description for the HEDIS Quality Specialist position at IntePros?
The HEDIS Quality Specialist supports quality reporting initiatives by performing medical record abstraction and over-read for HEDIS and State EQRO measures. This role ensures accurate data capture, compliance with technical specifications, and audit readiness.
Key Responsibilities
Key Responsibilities
- Perform medical record abstraction and over-read using HEDIS and State criteria
- Accurately document audit results in abstraction tools and databases
- Maintain productivity and accuracy standards (98% abstraction proficiency)
- Support medical record collection efforts with provider outreach as needed
- Participate in HEDIS audit processes (PSV, CSV, MRRV)
- Provide clinical and administrative support to providers
- 3–5 years of HEDIS chart review and abstraction experience
- Knowledge of HEDIS, QRS, or STARs measures and Technical Specifications
- Strong medical terminology knowledge (preventive care, immunizations, diabetic, maternity, pediatric)
- Experience with medical record abstraction tools
- Proficiency in Microsoft Excel, Word, Outlook
- Associate’s Degree, RN, LPN, or equivalent experience
- Must have LTSS experience (Long-Term Services and Supports)