HEDIS Abstractor - Medical Assistant
The Judge Group Inc.

Los Angeles, California

Posted in IT


This job has expired.

Job Info


Location: REMOTE
Description: We are currently sourcing for a
HEDIS Abstractor - With Medical Assistant Experience

REMOTE "WORK FROM HOME."

DO NOT APPLY UNLESS YOU HAVE THE COVID VACCINATION

What is your anticipated work schedule for this job posting?Monday - Friday, 8 hours, day shift Training is for 3 weeks. M-F 8:00am-5:00pm PST. This is a Pacific Time Zone area but candidates can be in all time zones. .After training, candidates may be able to work alternate scheduled based on time zones.
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.
  • 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.
  • 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.
  • Testing/IRR with passing score required prior to start date and continues throughout project. 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 5 month project and we are unable to consider staff who have planned vacations or other work commitments during the HEDIS season.
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 Anthem internal staff and designated lead in order to achieve goals and keep the project moving.
  • Reviews require data analysis and research within the Anthem 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.
EDUCATION AND EXPERIENCE:
  • Prior HEDIS experience a plus.
  • 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.
Please email your resume to Matt Mabry at mmabry@judge.com and reference JOB order # 788289I look forward to meeting you and discussing the opportunity for the 2022 HEDIS season.

Contact: mmabry@judge.com

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


This job has expired.

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