Hands-on experience in QA of HEDIS measure results
Strong understanding of NCQA HEDIS guidelines and specifications
Requirements:
Perform Quality Assurance (QA) on HEDIS measure charts and abstraction results
Review and validate accuracy, completeness, and compliance of HEDIS data
Analyze HEDIS measurement specifications and ensure adherence to NCQA guidelines
Conduct detailed chart reviews to identify gaps, inconsistencies, and coding errors
Job description
AAPC/AHIMA Certified Professional Coder || Eden Prairie, MN – Onsite || Fulltime || 6 - 15 years of experience
We are seeking a knowledgeable and experienced AAPC/AHIMA-certified Professional Coder to support Quality Assurance (QA) activities for HEDIS measure charts. The ideal candidate will have strong expertise in HEDIS measures, chart review, and quality validation, along with the ability to independently interpret NCQA guidelines.
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Key Responsibilities:
• Perform Quality Assurance (QA) on HEDIS measure charts and abstraction results
• Review and validate accuracy, completeness, and compliance of HEDIS data
• Analyze HEDIS measurement specifications and ensure adherence to NCQA guidelines
• Conduct detailed chart reviews to identify gaps, inconsistencies, and coding errors
• Interpret and apply HEDIS technical specifications during QA validation
• Perform independent research on HEDIS requirements using the NCQA manual
• Collaborate with internal teams to resolve discrepancies and improve data quality
• Provide feedback and recommendations to enhance QA processes and outcomes
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Required Qualifications:
• AAPC or AHIMA certification (mandatory)
• Proven experience in HEDIS measures and reporting
• Hands-on experience in QA of HEDIS measure results
• Strong understanding of NCQA HEDIS guidelines and specifications
• Ability to independently research and interpret NCQA manual requirements
• Solid knowledge of medical coding standards (ICD-10, CPT, HCPCS)
• Strong analytical skills and attention to detail
• Excellent communication and documentation skills
Diverse Lynx LLC is an Equal Employment Opportunity employer. All qualified applicants will receive due consideration for employment without any discrimination. All applicants will be evaluated solely on the basis of their ability, competence and their proven capability to perform the functions outlined in the corresponding role. We promote and support a diverse workforce across all levels in the company.
