Job Description
Job Title:
HEDIS Reviewer II
Address:
Working Offsite from Caremark Location anywhere in US. Please note: Actual location may vary. RI …
Job Description
- Participates in the collection and review of medical records to abstract clinical information for HEDIS quality reporting.
- Interprets relevant clinical criteria through review of medical records and annotates via Adobe PDF.
- Populates a data collection tool to support compliance with HEDIS and CMS performance measures.
- Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation standards.
- Completes assigned abstraction and data entry tasks daily with accuracy and efficiency.
- Coordinates with provider offices to schedule and confirm appointments, follow up on medical record submissions, and manage patient rosters.
- Locates and reviews all assigned medical charts, performs abstraction, copies supporting documentation, and enters data into applicable software systems.
Critical Information
- Fully remote, no onsite requirements.
- Work hours are Monday through Friday, 8am to 5pm local time, with flexible work hours possible.
- Proficient with databases, with all activities conducted on the computer.
- Must inform employer if planning employment with another company due to proprietary information.
- Participants may be selected for onsite visits to provider offices as needed for record collection.
- Work duration is project-based with varied hours; training provided prior to start.
- Ideal candidates have a reliable internet connection via Ethernet and reliable transportation if travel is required.
Education/Licenses Needed
- Verified High School Diploma or GED required.
- No specific licenses or certifications required.
Benefits:
- Benefits are available to full-time employees after 90 days of employment.
- A 401(k) with company match is available after 1 year of service.
- This is an AI-formatted job description; recruiter confirmation required.