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

Posted in Other 4 days ago.





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
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