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HEDIS Review Nurse

A Line Staffing Solutions

This is a Contract position in Houston, TX posted October 9, 2021.

Seeking to grow within the Healthcare Industry?

We are currently looking for a HEDIS Reviewer Nurse Remote Role Please submit your resume to this posting or contact Sarah from A-Line Staffing at 586-710-7983 (Call/Text) or sjonesalinestaffing.com (Email) HEDIS Reviewer Nurse (Remote) Participates in the collection and review of medical records to abstract clinical information for HEDIS quality reporting.

This position interprets relevant clinical criteria through review of medical records annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS and CMS performance measures.

Ensures accurate and complete documentation of required information to meet risk management regulatory and accreditation requirements.

Proven organizational and time management skills including the ability to meet required deadlines 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.

RN/LVN Required Hours Monday – Friday 8-5pm Required Experience 4 or more years of experience auditing and abstracting medical records required Medical knowledge/terminology Ability to read and interpret medical records.

Professional demeanor and good work ethic.

Computer savvy: Microsoft Word Excel email and Adobe reader required.

Excellent verbal and written communication skills
– clear concise and appropriate.

Job Requirements: LPN, Licensed Practical Nurse, Licensed Vocational Nurse, RN, PN, LVN, HEDIS, Registered Nurse, Milliman, InterQual, grievance, claims, management, audit, insurance, managed care, patient, patient healthcare, healthcare, medical, emr, medical records, dispute appeals, universal claims, complicated claims, outpatient, inpatient, telephonic, utilization review, prior authorizations, case management, prior authorization, disease management, concurrent review, hospital, providers, member services, managed care, quality management, risk management, acute care, chronic care, critical care