HEDIS Nurse

Job Title: Quality Improvement Abstractor Duration: 07 Months Contract (Possibility to extend) Location: Remote in NC Schedule: Working schedule M-F 8am-5pm EST Training 2-week course: M-F 8am-5pm EST – disclose any time off Payrate: $37-40/hr Responsibilities:

• Assist with retrieval of medical records.
• Works with the HEDIS Ops and Risk Adjustment teams to collect member records by contacting providers and placing collected records into database utilized
• Required to handle a high-volume (40-50 per day) of inbound and outbound calls with provider offices
• Continued follow up on requested medical records until obtained
• Excellent documentation of research and contact information
• Labeling records with appropriate naming convention
• Loading medical records to abstraction database
• Describe the performance expectations/metrics for this individual and their team
• TBD, but likely 40 – 50 calls/faxes per day

Requirements:

• Minimum 4 years of nursing experience (active RN required)
• At least 1 year of experience in medical record review, quality improvement, or related administrative clinical work, call center

Disqualifiers:

• No active RN/LPN license or lapsed/expired license
• Lack of experience with medical record systems or electronic documentation
• Inability to commit to full-time schedule during the contract period
• Limited computer proficiency (unable to navigate Excel or complete required computer testing)
• Refusal or inability to be on camera for required training and testing

Additional qualities to look for:

• Strong organizational skills and attention to detail
• Ability to handle a high-volume workload under tight timelines
• Professional communication and follow-up skills with provider offices
• Reliability and accountability in meeting daily call/fax and documentation expectations