HEDIS Abstractor-Glendale, CA
Location:
Glendale , California
Posted:
January 18, 2017
Reference:
1943362128
A HEDIS Abstractor position is available in Glendale, CA courtesy of Adecco Medical & Science. This is a project based position for the upcoming HEDIS auditing 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. Local travel may be required. 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
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 Anthem 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 Anthem specific platforms (i.e. Immunization registries, local claims system membership and defaulted claim information)


EDUCATION AND EXPERIENCE:

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 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
It is preferred that candidates have basic Excel skills and the ability to type 30-40 WPM
Prior HEDIS experience a plus

Please apply if you are interested in this HEDIS project or send your resume directly to Amber Helmuth at amber.helmuth@adeccona.com





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