Nurse HEDIS Reviewer

NTT DATA Services currently seeks a Nurse HEDIS Reviewer to join our team.  This is a remote role but must be open to working AZ hours and be a licensed RN or LPN in the state of AZ. Position requires advanced degree and licensing. BSN preferred

Licensed RN (preferred) or LPN with 3 years nursing experience (Note: license must be good in Arizona state)

HEDIS medical record reviewer for the HEDIS MY2024 Audit. Data will be retrieved from medical records obtained through a variety of methods. Position requires flexibility and the ability to work under pressure to meet hard deadlines. Qualified candidates will possess a professional demeanor and have a strong work ethic, be self-motivated, a conscientious problem solver, willing to learn, and take personal pride in their work performance/accuracy. Ideal candidates will have 3+ years of HEDIS record abstraction experience, proven organizational and time management skills, experience in a work-from-home scenario, and excellent verbal communication skills – clear, concise, and professional. Must be computer savvy with working knowledge of Microsoft Excel, Outlook, and Adobe preferred. Candidate must be able to commit to duration of the project.

Role Responsibilities
-Review, abstract and data enter all medical record data obtained via paper, electronic, CD, fax or mail
-Name and file medical record documents electronically, maintaining member PHI and PII
-Fax medical record requests to provider offices if requested
-Provide patient lists to provider offices
-Accurately enter data into Electronic Medical Record Review abstraction tool
-Communicate daily with Mercy Care support staff to review any changes in daily expectations
-Perform outreach calls as needed to provider offices to obtain medical records

Knowledge of MRR process is strongly preferred, especially HEDIS specific audit experience
-Experience with a variety of EMR systems strongly preferred
-Experience working from home and setting up home office
-Experience reading and interpreting medical records, including handwritten records

Required Skills/Experience  
What are the required skills for this role?  (3-5 at the most).  Points to emphasize

• 3+ years HEDIS specific audit experience. 
• 3 years experience with a variety of EMR systems 
• 3+ years experience working from home and setting up home office
• 3+ years experience reading and interpreting medical records, including handwritten records