Job Description

Job Description

Job Description

Description:

Position Summary

The Quality Measures Abstractor is a full-time position that is responsible for reviewing and abstracting medical records for quality measures to support performance in value-based contracts. The Quality Measures Abstractor reviews medical records according to measure specifications (HEDIS, CMS, Payers, Quality Program, etc.). The data is entered into database tool for reporting. Attests to quality measure information in payer systems. Communicates quality or medical record deficiencies to practices. Performs other duties as assigned.

Essential Duties and Responsibilities

• Reviews and abstracts medical record data for quality reporting
• Knowledgeable of quality metric specifications by payer and how to accurately abstract quality measure data
• Understands what data must be reported to each payer and in what format/software
• Accurately and efficiently reviews chart for data collection and reporting
• Advises and educates provider practices in appropriate measures and medical record documentation guidelines in accordance with measure specifications. This may include development of educational tools i.e., handouts, newsletter articles
• Intervenes when payer attribution to a provider is not accurate according to department processes, which may include outreach to parent
• Serves as department liaison for practice engagement, including phone calls and emails
• Collects provider performance data to support opportunities for provider improvements
• HIPAA compliance

Position requires normal business hours Monday-Friday. This position offers work-at-home option for employees who meet performance requirements, with occasional on-site meetings. Candidate must be able to maintain HIPAA privacy requirements when working from home. Candidate must be located in the East Tennessee region.

Full benefit package available, including PTO, Medical, Dental, Vision, STD, LTD, Life Insurance, and more!

· Licensed Practical Nurse or Medical Assistant preferred (LPN/MA)

· Knowledge of medical terminology required.

· Basic comprehension of lab data, diagnostic reports, and other areas of medical record required.

· Ability to efficiently navigate electronic medical record required.

· Strong attention to detail and accuracy required.

· Knowledge of medication names and broad drug classification preferred.

· 2+ years of recent HEDIS Review experience strongly preferred. This may include having served in a clinical role in a practice with responsibilities for quality gaps.

· Excellent oral and written communication skills including good grammar, voice, and diction.

· Ability to prioritize, multi-task, and achieve goals on time; work independently and to self-motivate.

· Must be proficient in computer programs including Microsoft Office (Excel, Outlook, PowerPoint, Word, etc.) and website navigation.

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