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HEDIS Reviewer II

Remote: 
Full Remote
Contract: 
Fixed term
Experience: 
Mid-level (2-5 years)
Work from: 
United States

Offer summary

Qualifications:

High school diploma or GED, Knowledge of HEDIS and data entry, Familiarity with healthcare documentation, Strong communication skills.

Key responsabilities:

  • Conduct outreach to members and providers
  • Review medical records for HEDIS reporting
US Tech Solutions logo
US Tech Solutions Large https://www.ustechsolutions.com/
1001 - 5000 Employees
About US Tech Solutions
USTECH SOLUTIONS is the largest privately owned diversity workforce partner with a global footprint. For 20+ years, we have partnered with leading MSPs and some of the world’s largest enterprises to deliver a flexible workforce. We serve Fortune 500 giants and growing businesses alike, reinventing the role of humans in a digital workforce. ‘Reinventing Human’ is about connecting you with top talent and seamlessly integrating new hires into your programs through our next gen AI powered Talent platforms. As the largest private diversity supplier in the US, we champion inclusion and unlock hidden potential. We work with leading MSPs and are a trusted strategic partner to the world’s top brands. At USTECH SOLUTIONS, we're inverting the talent hiring pyramid by offering a range of solutions from curated talent pools, workforce management services, and IT services resourcing to IC compliance. Our legacy and close affinity to the computing industry has equipped us with the expertise and vision to provision AI platform solutions that help organizations to innovate faster. Considering Statement of Work? Meet US Tech Digital (ustechdigital.com). We're helping businesses achieve digital leadership through our tailored SOW solutions, utilizing market-leading technology products and our proprietary in-house developed platform solutions. Explore our full range of services and solutions by visiting our website: ustechsolutions.com
See more US Tech Solutions offers

Job description

Summary:
Participates in the member and provider outreach, collection, and review of medical records to abstract clinical information for HEDIS quality reporting. Training will be provided prior to the start of the assignment.
 
Duties:
• Outreach to members to complete survey to address Social Determinants of Health (SDoH) barriers and provide helpful resources
• Outreach to members and clinical providers to effectively coordinate care, obtain medical records and ensure patients receive preventive and chronic disease management services. The goal of these messages is to remind providers, identify if any screenings have already been performed and, if they have not been completed, to assist in any way possible to complete the screenings.
• Search for relevant HEDIS records from databases, review medical records using HEDIS technical specification criteria or internal guidelines, and make annotations via Adobe PDF.
• Ensure accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements.
• Perform duties for additionally adhoc projects such as provider outreach to verify demographics and faxing providers.
 
Experience:
• Complete 60-75 outreach calls to members per day to address HEDIS gaps and provide resources on Social Determinants of Health
• Use multiple platforms and tools to search for relevant member records
• Complete assigned research lists, fax lists, and calls lists each day
• Work with provider offices as needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters
• Locate and review ALL assigned medical charts, perform abstraction, copy all supporting documentation per specifications and data enter into the applicable software system ALL assigned abstracts.
• Prioritize and accurately complete tasks within established times
• Identifying trends and documentation of areas for improvement
• Maintaining project productivity levels while maintaining accuracy requirements for abstraction and data entry activities
 
Education:         
               
High school diploma or GED
 
Skills:   
 
HEDIS, data entry
 
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com.
 
US Tech Solutions is an Equal Opportunity Employer.  All qualified applicants will receive consideration for employment without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Required profile

Experience

Level of experience: Mid-level (2-5 years)
Industry :
Human Resources, Staffing & Recruiting
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Hard Skills

HEDIS (Healthcare Effectiveness Data And Information Set)Data Entry

Other Skills

  • Time Management
  • Communication
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