HEDIS Abstractor - Medical Assistant
The Judge Group Inc.

Job Info

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Location: Tampa, FL
Description: HEDIS Abstractor - Medical Assistant (Temporary REMOTE)

Local travel may be required.
Anticipated work schedule: 7am to 7pm

HEDIS experience:

• Candidates will be required to participate in training and pass IRR Testing in order to participate in the project. This will be conducted over the first 2-3 weeks of the project
• Testing/IRR with passing score required prior to start date and continues throughout project.
• Must be comfortable reviewing electronic medical records; working with dual monitors.
• Abstractor will be responsible for reviewing a high volume of medical records with high skilled accuracy.
• Productivity standards to be met.
• Training on claims systems will also be provided to support Research as needed.
• Must be flexible in this fast paced environment with changing priorities throughout project.

Please note this is a short term project and we are unable to consider staff who have planned vacations or other work commitments during the HEDIS season.

SUMMARY:

• Candidate will work with the HEDIS team to collect member records and conduct reviews of these records by contacting providers and placing the results collected into a specific data base.
• If necessary the medical record review is conducted on site in provider office or hospital institution.
• This candidate will be required to handle a high volume of telephonic interaction with provider offices.
• Candidates must follow up on requested medical records with providers.
• Must keep excellent documentation of research and contact information.
• Candidate must pass a medical record abstraction test prior to starting actual 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.
• Sharing of department responsibilities as assigned.
• Must be flexible and willing to develop and share strategies to accomplish goals.
• Required to perform research on internal claims systems.
• Work under the supervision of internal staff and designated lead in order to achieve goals and keep the project moving.
• Reviews require data analysis and research within the company data systems.
• 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.
• Examples of deep dive research would be based on company specific platforms (i.e. Immunization registries, local claims system membership and defaulted claim information).
• Candidates must have excellent skill set to read and interpret physician handwriting.
• Candidates must live within an acceptable commuting distance and reliable transportation is required.
• Work attire is professional casual.

EDUCATION AND EXPERIENCE:

• Requires a Medical Assistant certification with an AS (Associate in Science) degree and/or has worked as office manager/ admin to a medical office and or assistant to physician and nurses in reviewing of medical records, applying codes for billing/claims, processing files and submitting to insurance or other requested agencies.
• Must understand medical terminology.
• Works under the direction of a HEDIS Lead as a crossover position from abstractor to researcher.
• Candidates must have prior experience with research and either HEDIS measures or auditing data submitted as claims.
• 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.
• Knowledge of Microsoft office is required.
• Requires effective written, oral, and interpersonal communication skills.
• Candidates must have basic Excel skills and must have the ability to type 30-40 WPM.
• Prior HEDIS experience a plus.

Contact: mmabry@judge.com

This job and many more are available through The Judge Group. Find us on the web at www.judge.com

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