Clinical - Quality Improvement Abstractor

1 month ago


Atlanta, United States Axelon Full time

Location: Remote - GA

Shift: M-F
8am - 5pm
Voluntary OT available in Dec and Jan. OT will be required beginning in March 2025 ( approximately 10 hours per week) During April weekend work is expected / required.
Duration: This is a TEMPORARY role, Position will be termed 5/9/2025

Walk me through the day to day responsibilities of this the role and a description of the project:

  • bstract and Overread medical records. Assist with provider chase assignment.
Responsibilities:
  • ssess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom or other measure set standards
  • Review medical records and abstract data for HEDIS and other measure sets in compliance with standards
  • Track and report on issues and outcomes related to abstractions and over-reads
  • Communicate outcomes of abstraction and over-sight activities with health plans and vendors when required
  • Perform other quality initiatives as necessary
Describe the performance expectations/metrics for this individual and their team:
  • Flexibility. Meet assigned weekly productivity goals. Pass HEDIS measure tests. SME for assigned HEDIS measure(s).
Job Description: Position Purpose: Lead data collection and abstraction for company quality measures, including HEDIS, CMS, CHIPRA and/or any other custom measurements.

Education/Experience: Associate's degree in related field or equivalent experience. Bachelor degree preferred.
Required Skills/Experience: Preferred Skills/ Experience: 1. Strong knowledge of HEDIS Measures and Technical Specifications 1. Strong knowledge of HEDIS Measures and Technical Specifications 2. Experience in quality initiatives (including HEDIS project, study analysis, or NCQA standards) preferred. 2. Experience in quality initiatives (including HEDIS project, study analysis, or NCQA standards) preferred. 3. dvanced knowledge of Microsoft Applications, including Excel and Access. 3. dvanced knowledge of Microsoft Applications, including Excel and Access. 4. Medical coding or data management experience. 4. Medical coding or data management experience. Education Requirement: ssociate degree in related field or equivalent experience. Bachelor's degree preferred. 4+ years of nursing, medical assistant, Education Preferred: LPN, RN, Coder, Medical Assistant w/ strong HEDIS Experience Software Skills Required: dvanced knowledge of Microsoft Applications, including Excel and Access. QSHR experience a bonus Required Certifications: LPN or RN Required Testing:

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