HEDIS Abstractor - Nurse
The Judge Group Inc.

Atlanta, Georgia

Posted in IT


Job Info


Location: REMOTE
Salary: Dependent on Experience
Description:
Judge Healthcare is seeking REMOTE HEDIS Abstractor- Nurse in Florida ASAP!

Job Details:

Title: Remote Hedis Abstractor- Nurse

Number of Openings: 10

Location: Remote - must live in FL

Type of Engagement: Contract

Rate: Competitive and Dependent on Experience

Specific Duties:

  • Candidate will work with the HEDIS team to collect member records and conduct reviews of these records by contacting providers and placing the results collected into a specific data base.
  • If necessary the medical record review is conducted on site in provider office or hospital institution.
  • Required to handle a high volume of telephonic interaction with provider offices.
  • Candidates must follow up on requested medical records with providers.
  • Must keep excellent documentation of research and contact information.
  • Candidate must pass a medical record abstraction test prior to starting actual record reviews.
  • This is a high production environment and candidates must adhere to measured productivity requirements, module testing and at times retesting to meet minimum requirements.
  • Sharing of department responsibilities as assigned.
  • Required to perform research on internal claims systems.
  • Must be flexible and willing to develop and share strategies to accomplish goals.
  • Work under the supervision of internal staff and designated lead in order to achieve goals and keep the project moving. Reviews require data analysis and research within the Anthem data systems.
  • Candidates must have excellent skill set to read and interpret physician handwriting.
  • Candidates must live within an acceptable commuting distance and reliable transportation is required.
  • Work attire is professional casual.
  • Candidates must have critical thinking skills as they will conduct research in a thoughtful and methodical search in order to locate specific claim information.
  • Research includes all resources provided in order to find best information.
  • Examples of deep dive research would be based on specific platforms

Qualifications:

  • Hedis Experience is a must
  • Requires a licensed nurse; RN, LPN, LVN, Licensed professional graduate of an accredited school of nursing.
  • Candidates must have computer skills and analysis capabilities in order to navigate CPT4 code and ICD9 and ICD10 DX based on HEDIS Technical Specification requirements.
  • Candidates must understand codes for services based on diagnosis and procedure.
  • They must be research and detail oriented with the tenacity to find claim specific data for a specific measure within a given period of time.
  • Knowledge of Microsoft office is required.
  • Requires effective written, oral, and interpersonal communication skills.
  • It is preferred that candidates have basic Excel skills and the ability to type 30-40 WPM.

Hours:

  • Monday-Friday 8am-5pm

Please send your resume to Dominique DeMarco - DDeMarco2@judge.com for immediate consideration.

Thank you for your time and I look forward to hearing from and working with you.

Regards,

Dominique DeMarco

Recruiter

The Judge Group

Contact: ddemarco2@judge.com

This job and many more are available through The Judge Group. Find us on the web at www.judge.com



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