LPN or RN- Clinical Specialist - Contract

NFuzionIT - Louisville, KY

Contract

We’re hiring HEDIS Abstractor RN or LPN, Clinical Specialist (Abstractor)

This is contract opportunity: Starting December 2nd and going until May 2020

POSITION SUMMARY:

Candidate will work with closely with the HEDIS team to review prepared member records and conduct forensic reviews. Candidate will be an expert in identifying, collecting, and recoding data into a prescribed specific data base. Must keep excellent documentation of research and contact information. Candidate must pass a medical record abstraction test prior to starting record reviews.

MAJOR DUTIES AND RESPONSIBILITIES:

· This is a high production environment and candidates must adhere to measured productivity requirements, module testing and at times retesting to meet minimum requirements.

o Sharing of department responsibilities as assigned.

· Candidate is required to perform research on internal claims systems.

o Must be flexible and willing to develop and share strategies to accomplish goals.

· Candidate will work under the supervision of internal staff and designated lead in order to achieve goals and keep the project moving.

· Candidate will analyze required data and research within data systems.

· Candidate must have excellent skill set to read and interpret physician handwriting.

· As applicable, candidates must live within an acceptable commuting distance and reliable transportation is required. Work attire is professional casual.

· Candidates must have critical thinking skills as they will conduct research in a thoughtful and methodical search in order to locate specific claim information.

· Research includes all resources provided in order to find best information.

o Examples of deep dive research would be based on specific platforms (i.e. Immunization registries, local claims system membership and defaulted claim information).

· Must be flexible and willing to develop and share strategies to accomplish goals.

· Required to perform research on internal claims systems.

REQUIRED EXPERIENCE AND KNOWLEDGE:

· Candidate requires a licensed professional graduate of an accredited school of nursing including, RN, LPN, LVN.

· Candidates must have computer skills and analysis capabilities in order to navigate CPT4 code and ICD9 and ICD10 DX based on HEDIS Technical Specification requirements.

· Candidates must have an understanding of codes for services based on diagnosis and procedure, they must be research and detail oriented with the tenacity to find claim specific data for a specific measure within a given period of time.

· Requires effective written, oral, and interpersonal communication skills.

· Knowledge of Microsoft office is required.

· It is preferred that candidates have basic Excel skills and the ability to type 30-40 WPM.

· Prior HEDIS experience a plus.

Job Type: Contract

Experience:

  • HEDIS: 2 years (Preferred)
  • Chart Abstraction: 4 years (Preferred)

License:

  • LPN (Preferred)