We’re hiring HEDIS Abstractor RN or LPN, Clinical Specialist (Abstractor)
This is contract opportunity: Starting December 2nd and going until May 2020
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