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Remote - HEDIS Abstractors / HEDIS Reviewers

Role overview

Summary

This role focuses on conducting data collection and abstraction of medical records for HEDIS projects under the supervision of the Medical Record Review team. You will support HEDIS reporting and quality improvement initiatives while adhering to compliance standards.

Qualifications

  • Minimum of 2 years of prior work experience in HEDIS abstraction or review.
  • Medical Coder Certification: CPC, CCS, RHIT, RHIA through AAPC or AHIMA OR Licensed Nurse: LPN, LVN, RN with an active license.
  • Own a Windows 10/11 laptop, preferably Windows Professional Edition.
  • High-speed internet access and video-call capabilities.
  • Preferred: Availability to work between 6:00 am EST and 6:00 pm EST, with a minimum commitment of 4 hours per day.

Responsibilities

  • Conduct data collection and abstraction of medical records for HEDIS projects.
  • Review medical records and transfer critical HEDIS data elements into a data entry portal.
  • Maintain accuracy thresholds as set forth by Advantmed.
  • Comply with HIPAA laws and regulations.

Key facts

  • Remote from: United States
  • Part time
  • Mid-level (2-5 years)
  • $52K / year
  • English

Hard skills

Other skills

  • Time Management
  • Detail Oriented

About the company

Advantmed logo

Advantmed

  • Digital Health
  • Large
  • 1,001–5,000
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.

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Job description

HEDIS Reviewers / Abstractors

Job Types: Seasonal

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

Candidates must have their own Windows 10/11 laptop (preferably Windows Professional Edition), along with high-speed internet access and video-call capabilities.

Pay Structure:

  • The training pay rate is $20/hour
  • Live Season Pay Rate: $27/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 / seasons of prior work experience in HEDIS abstraction / Review in any of these measures: BPD, CBP, PPC, TRC ,WCC, GSD, COA, etc.
  • Medical Coder Certification: CPC, CCS, RHIT, RHIA through AAPC or AHIMA OR
  • Licensed Nurse: LPN, LVN, RN with an active license

Candidates must have their own Windows 10/11 laptop (preferably Windows Professional Edition), along with high-speed internet access and video-call capabilities.

Working Schedule:

  • Candidates must complete the required training within the designated timeframe, which may include recorded, self-paced, and/or live instructor-led sessions covering key measures and program requirements.
  • 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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