HEDIS Abstractor - Medical Assistant at The Judge Group Inc. in Tampa, Florida

Job Description:

Location: Tampa, FL

Description: HEDIS Abstractor - Medical Assistant (Temporary REMOTE)




Local travel may be required.

Anticipated work schedule: 7am to 7pm




HEDIS experience:

• Candidates will be required to participate in training and pass IRR Testing in order to participate in the project. This will be conducted over the first 2-3 weeks of the project


• Testing/IRR with passing score required prior to start date and continues throughout project.


• Must be comfortable reviewing electronic medical records; working with dual monitors.


• Abstractor will be responsible for reviewing a high volume of medical records with high skilled accuracy.


• Productivity standards to be met.


• Training on claims systems will also be provided to support Research as needed.


• Must be flexible in this fast paced environment with changing priorities throughout project.

Please note this is a short term project and we are unable to consider staff who have planned vacations or other work commitments during the HEDIS season.




SUMMARY:

• 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.


• This candidate will be 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.

MAJOR DUTIES AND RESPONSIBILITIES:

• 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.


• Must be flexible and willing to develop and share strategies to accomplish goals.


• Required to perform research on internal claims systems.


• 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 company data systems.


• 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 company specific platforms (i.e. Immunization registries, local claims system membership and defaulted claim information).


• 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.

EDUCATION AND EXPERIENCE:

• Requires a Medical Assistant certification with an AS (Associate in Science) degree and/or has worked as office manager/ admin to a medical office and or assistant to physician and nurses in reviewing of medical records, applying codes for billing/claims, processing files and submitting to insurance or other requested agencies.


• Must understand medical terminology.


• Works under the direction of a HEDIS Lead as a crossover position from abstractor to researcher.


• Candidates must have prior experience with research and either HEDIS measures or auditing data submitted as claims.


• 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 have an understanding of 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.


• Candidates must have basic Excel skills and must have the ability to type 30-40 WPM.


• Prior HEDIS experience a plus.

Contact: mmabry@judge.com


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