HEDIS Over Reader Nurse – Contract

This is a fully remote position, open to applicants in Texas.

📋 Description

• Review medical record abstractions performed by the HEDIS abstraction team with precision and efficiency on a daily basis, adhering to HEDIS specifications and company training protocols.

• Utilize the IRR/over-read tool within the Software Application, providing comments when errors are detected. Rectify any mistakes identified during the over-read process, including re-evaluating charts that may have similar inaccuracies.

• Detect and report abstraction errors while offering re-education on measures for the abstractor.

• Employ various software applications to facilitate HEDIS operations by inputting data and/or modifying chase statuses for the designated chase(s).

• Collaborate with the HEDIS Coordinator and/or QI Specialists to review HEDIS initiatives, address any outstanding issues, and discuss IRR results.

• Achieve productivity standards as established by the HEDIS Coordinator/QI Department.

• Ensure compliance with all HIPAA regulations and patient confidentiality standards.

• Perform additional duties as assigned.

⛳️ Requirements

• Degree, Diploma, or Certificate from a nursing program accompanied by clinical experience.

• Licensed to practice in the State of Illinois.

• Familiarity with medical terminology.

• Experience in data entry and/or typing.

• Strong written and verbal communication skills that are clear and concise.

• Proficient in PC applications, including Word, Excel, and Lotus Notes.

• Auditing experience is preferred.

🏝️ Benefits

• Comprehensive health benefits package.

• Opportunities for professional development and training.

• Flexible working hours and remote work options.

• Supportive and collaborative work environment.