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Remote - HEDIS Abstractors / HEDIS Reviewers (6600)

Role overview

Qualifications

  • Minimum of 2 years or 2 seasons of prior work experience in HEDIS abstraction/Review
  • Medical Coder Certification: CPC, CCS, RHIT, RHIA through AAPC or AHIMA OR Licensed Nurse: LPN, LVN, RN
  • Possess a Windows-based laptop or desktop computer
  • Access to a high-speed internet connection

Responsibilities

  • Reviewing medical records and transferring critical HEDIS data elements into a specified data entry portal
  • Data entry into Advantmed proprietary software
  • Maintain accuracy thresholds as set forth by Advantmed
  • Comply with HIPAA Laws and regulations

About the company

Advantmed logo

Advantmed

Digital Health & Health Tech

Advantmed is a privately held company founded in 2005. The organization initially focused on record retrieval but has evolved into an innovative healthcare information management company that helps health plans and Managed Care Organizations optimize revenue and improve quality outcomes. Our mission is to improve the healthcare system by ensuring appropriate, quality care and eliminating unnecessary costs. We accomplish this by providing a cost-effective suite of capabilities tailored to the unique needs of our clients, including NCQA-certified HEDIS® measure software, risk analytics, medical record retrieval, medical record abstraction, risk adjustment coding, data validation, prospective assessments, and provider education. Our strategy reflects our flexibility and commitment to meeting our clients' evolving needs. We work closely with our clients to understand their concerns, requirements, strategic objectives, and infrastructure so that we can support them accordingly. Our foundational principles are accuracy, efficiency, and transparency. Our solutions are designed to be user-friendly and flexible. We see ourselves as an extension of our clients’ internal teams, which allows us to work to advance our solutions and provide support for their growing business needs. Understanding how our clients use our products and services fuels our product development road map, especially in terms of technology as we continually work to improve our client portal. In addition, we regularly monitor statutory and regulatory changes from CMS, HHS, NCQA, and others. The Advantmed leadership team is composed of seasoned healthcare veterans, with extensive quality and risk adjustment expertise. The leadership team oversees a global staff of over 1,800 employees. Notably, we are HITRUST certified, and all data resides within the United States.

Company details

Company typeLarge
IndustryDigital Health & Health Tech
Company size1001 - 5000

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Job description

HEDIS Reviewers / Abstractors

Job Types: Seasonal / Part-time

  • This is a remote position available to candidates located within the United States. Applicants must be eligible to work in the United States.

Pay Structure:

  • The training pay rate is $20/hour
  • Live Season Pay Rate: $24/hour

Primary Purpose: Under the supervision of the Medical Record Review team, the HEDIS Abstractor conducts data collection and abstraction of medical records for HEDIS projects, HEDIS-like projects, and supplemental data collection. The abstraction team will meet chart abstraction productivity standards.

 

Job Roles and Responsibilities

  • Responsible for reviewing medical records and transferring critical HEDIS data elements into a specified data entry portal to support HEDIS reporting and quality improvement.
  • Data entry into Advantmed proprietary software.
  • Maintain accuracy thresholds as set forth by Advantmed.
  • Comply with HIPAA Laws and regulations
  • Attend self-paced recorded training within a defined timeframe for required measures.

Requirements

Experience

  • Minimum of 2 years or 2 seasons of prior work experience in HEDIS abstraction/Review in any of these measures: BPD, CBP, GSD/HBD, COA, CIS, IMA, CCS, EED, LSC, COL, TRC, PPC or WCC. 
  • Specifically looking for expertise in all sub-measures of these full HEDIS measures: TRC, PPC, WCC measures
  • Medical Coder Certification: CPC, CCS, RHIT, RHIA through AAPC or AHIMA OR
  • Licensed Nurse: LPN, LVN, RN with an active license
  • The applicant must possess a Windows-based laptop or desktop computer and have access to a high-speed internet connection.

Working Schedule:

  • Candidates must complete a self-paced, recorded training program within a designated timeframe, covering key measures.
  • Post-training, candidates must be available to work between 6:00 am EST and 6:00 pm EST, with a minimum commitment of 4 hours per day and a maximum of 8 hours per day.
  • Chart reviews will follow on a first-come, first-served basis each day, with no option for split shifts.
  • Weekend availability may be available, depending on upper management's decision as the live season progresses.

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Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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