Job Description
Job Description:
- Coordination of the medical records identification process, collection activities and review.
- Performing and applying structured auditing abstraction criteria to medical records to determine compliance.
- Utilizing various software applications to support department operations and accurately entering the results of chart audits into the database.
- Developing and maintaining expertise in the requirements and parameters of mandated HEDIS and State performance measures.
- Completing medical record review abstraction and overread and providing feedback for medical records that do not meet the HEDIS or State Measure Technical Specifications criteria within a live software environment.
- Providing clinical and administrative support to providers as directed.
- Maintaining productivity level of a minimum of chases/charts per defined period according to policy.
- Maintaining an abstraction proficiency rate of 98% by correctly reading, interpreting, and abstracting various components of the medical record such as notes, consultations, medication forms, treatment plans, health history, interval history, and past history.
Skills:
- Three to five years working with HEDIS data including chart review/collection. HEDIS, QRS, or STARs experience. Knowledge of medical terminology and basic charting to include diabetic labs, HPV testing, preventive health screenings, immunization and well-care terminology for children, adults and pregnant women.
- Understanding of current HEDIS Technical Specifications.
- Knowledgeable in the HEDIS audit process (PSV, CSV and MRRV).
- Proficiency in Excel, Word, Power Point and Outlook.
- Experience with medical record abstraction tool(s) and wiliness to learn any medical record abstraction tool.
- Experience in the Pediatric, Maternity, Diabetic or Provider Office Setting.
- Familiar with the Cancer Registry.
- Familiar with Bright Futures.
Education:
- Associates Degree, RN, LPN, or relevant work experience