Title: Healthcare Consultant II.
Location: Fully Remote.
Contract Duration: 5+ months.
Pay Rate: $35.00/ Hr on W2.
Hrs / Wk: 40.00.
Shift: Monday - Friday, 8 hours worked a day, between the hours of 8am and 5pm local time.
Description:
Participates in the audit/over read of the medical record collection and review process for HEDIS quality reporting.
Training will be provided prior to the start of the assignment.
- This position audits and interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and audits data populated within 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 requirements.
- The candidate must be proficient with databases and with conducting 100% of work activities on the computer.
Job Duties:
- Auditing of information entered into the software system for abstraction and data entry based on HEDIS MY 2020 Technical Specifications.
- Prioritize and accurately complete tasks within established times.
- Identifying trends and documentation of areas for improvement.
- Maintaining project productivity levels while maintaining accuracy requirements for abstraction and data entry activities.
Work Experience:
- 5 or more seasons of HEDIS experience in reviewing medical records is required.
- Prior experience in performing chart audits is preferred.
- Candidate must commit to attend all required training and conference calls assigned for the project.
- Candidate must return all equipment that is supplied to them in good working condition and in a timely manner at the end of the project.
- Medical knowledge/terminology is required.
- Ability to read and interpret medical records.
- Professional demeanor and good work ethic.
Computer Skills:
- Microsoft Word, Excel, email, and Adobe reader required. Know how to save a file to a folder.
- Excellent verbal and written communication skills – clear, concise and appropriate.
- Conscientious problem solver, willing to learn, and take personal pride in their work performance/ accuracy.
- Exceptional attention to detail and excellent analytical, investigation, and problem-solving skills.
- Proven organizational and time management skills including the ability to meet required deadlines.
- Must keep all information collected in a safe, organized and confidential manner while maintaining. confidentiality of PHI, HIPAA Privacy and Security Rules.
Education:
RN/LVN with an associate or bachelor degree is preferred but not required.
Successful HEDIS review experience may be substituted for licensure.