Remote HEDIS Audit Overread Specialist | WFH

Job Overview

Join our dynamic team as a HEDIS Audit - Overread specialist in a full-time remote position. We seek a dedicated professional who is committed to enhancing the quality of healthcare through accurate data reporting and auditing. This role is integral to our healthcare compliance initiatives, ensuring that medical records align with HEDIS quality standards.

Key Responsibilities

• Conduct thorough reviews and audits of medical records for HEDIS quality reporting, adhering to established guidelines and protocols.
• Employ clinical criteria to evaluate and annotate medical records using Adobe PDF and various data collection tools, affirming compliance with HEDIS and CMS performance metrics.
• Guarantee that documentation is complete and accurate to meet risk management, regulatory, and accreditation standards.
• Audit data entry in our software system as per HEDIS MY 2020 Technical Specifications.
• Identify trends and suggest improvements to enhance the quality and accuracy of data reporting.
• Maintain high productivity levels while ensuring precision in data entry and abstraction tasks.
• Effectively prioritize responsibilities and meet established deadlines.
  
  

Required Skills

• A minimum of 5 seasons of HEDIS experience in reviewing medical records is essential.
• Proficiency with databases and a strong ability to conduct all work activities on a computer is critical.
• A keen attention to detail, a commitment to deadlines, and a focus on accuracy in both data entry and auditing tasks.
  
  

Qualifications

• Prior experience performing chart audits is advantageous.
• An RN/LVN with an associate or bachelor's degree is preferred but not required.
• Successful HEDIS review experience may substitute for licensure.
  
  

Career Growth Opportunities

This position provides a pathway for ongoing professional development in healthcare compliance and auditing, allowing you to expand your expertise in a vital field.

Company Culture And Values

Our organization prides itself on fostering a collaborative and detail-oriented atmosphere, where accuracy and compliance in healthcare quality reporting are paramount. We actively support our employees in achieving their professional aspirations.

Compensation And Benefits

• Comprehensive benefits package, including medical, dental, vision, and life insurance.
• Retirement options.
  
  

Employment Type: Full-Time