Description: The Judge Group is currently looking for HEDIS Nurse Abstractors to work REMOTE!
Job Summary:
Join our HEDIS team to collect and review member records by contacting providers and entering results into a database. This role involves high-volume telephonic interactions with provider offices, following up on requested medical records, and maintaining excellent documentation of research and contact information. Candidates must pass a medical record abstraction test before starting actual record reviews.
Major Duties and Responsibilities:
Adhere to productivity requirements in a high-production environment.
Perform research on internal claims systems.
Develop and share strategies to achieve goals under the supervision of internal staff and designated leads.
Conduct data analysis and research within data systems.
Read and interpret physician handwriting accurately.
Maintain professional casual work attire.
Utilize critical thinking skills for methodical research to locate specific claim information.
Conduct deep dive research using Anthem-specific platforms (e.g., immunization registries, local claims system membership, and defaulted claim information).
Education and Experience:
Licensed nurse (RN, LPN, LVN) with a degree from an accredited nursing school.
Proficient in computer skills and analysis, including navigating CPT4 codes and ICD9/ICD10 DX based on HEDIS Technical Specifications.
Understanding of service codes based on diagnosis and procedure.
Detail-oriented with strong research skills and tenacity to find claim-specific data within a given timeframe.
Proficient in Microsoft Office, with basic Excel skills and the ability to type 30-40 WPM.
Effective written, oral, and interpersonal communication skills.
Prior HEDIS experience is a plus.
If this sounds like something you'd be interested in, please reply with updated resume!
Christina Head, Sr. Healthcare Recruiter
chead@judge.com
Contact: chead@judge.com
This job and many more are available through The Judge Group. Find us on the web at www.judge.com
