Remote HEDIS Reviewer II — Compliance & Medical Records
SGS Consulting
- Remote job
A leading consulting firm is seeking a HEDIS Reviewer II for a remote position. The role involves interpreting clinical criteria through medical records, ensuring accurate documentation for compliance with HEDIS and CMS. Candidates must possess a high school diploma or GED and demonstrate proficiency in relevant medical knowledge, communication skills, and computer applications like Microsoft Word and Excel. This position emphasizes attention to detail and accuracy in data collection. #J-18808-Ljbffr SGS Consulting
- ...HEDIS Reviewer II job at SGS Consulting. Remote. Job Responsibilities: This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS and CMS performance...Remote workHEDIS
$52k - $83k
...Insurance Companies is seeking a fully remote Premium Audit Reviewer II to evaluate and review premium audits for accuracy and compliance. This role requires strong analytical skills... ...as comprehensive benefits including medical, dental, and PTO. Join a team that emphasizes...Remote job- ...HEDIS Reviewer III job at SGS Consulting. Remote. Job Responsibilities: Work from home in Michigan area. Position will potentially make onsite visits... ...needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters. Locate and...Remote workHEDISLive inWork from home
- ...Star Ratings, drive clinical quality indicators (HEDIS Star metrics), CAHPS, and HOS efforts. Key... ...Supports various HEDIS activities as needed, including medical record retrieval. Maintains the highest level of compliance. Excellent verbal and written communication...Remote workHEDIS
$89.8k - $176.7k
...The person will review charts (paper... ...with physicians, medical groups, IPAs... ...increase their HEDIS performance, facilitate... ...Scorecard, CPT II Report) to... ...) and 40% remote work You’ll be... ...electronic medical records) Experience in... ...improve provider compliance Proven ability...Remote workHEDISMinimum wageFull timeWork experience placementWork at officeLocal area$93.4k - $116.8k
...including quality of care reviews, incident investigation, and regulatory compliance? VNS Health Plans is... ...you and your loved ones, Medical, Dental, Vision, Life... ...of patient/member case records. Develops forms, record... ...medical record reviews for HEDIS or other related...Remote workHEDISWork experience placementFlexible hours- ...HSCRC Coding Reviewer At Commence, we're the start of a new age of data-centric... ...methodologies that are based in medical record documentation. Performs compliance audits employing specified... ...essential functions. This is an office/remote position. While performing the...Remote workContract workWork at office
$20 - $23 per hour
...involves performing data analysis, managing medical records while ensuring HIPAA compliance, and coordinating with multiple stakeholders in a fully remote setting. Ideal candidates will have experience in Risk Adjustment or HEDIS and possess strong Excel skills. The...Remote jobHEDISHourly pay$59.7k
...Job Type: Full-Time Remote Employment: Flexible/Hybrid... ...Architecture: Building Plans Reviewer (Project Manager I/II/III) is responsible for... ...for building permits for compliance with Building Codes and other... ...benefits with paid medical insurance, 20 days of PTO...Remote workFull timeTemporary workWork experience placementInternshipFlexible hours$102.55k - $115.37k
...will oversee retrospective and prospective chart review programs while supervising the Risk Adjustment... ...bridge between Risk Adjustment and the HEDIS/Quality abstraction team, the manager ensures that all medical record interactions are utilized effectively for Hierarchical...Remote workHEDISFull timeWork experience placement$22.91 - $32.99 per hour
...accurate level of service in compliance with Medicare/Medicaid... ...Benefits: ~2 Medical plans to choose from,... ...the potential for remote work following that period... ...and carefully reviews documentation, reports... ...information from the medical records to address coding...Remote workHourly payFull timeWork experience placementWork at office- ...physicians to conduct Independent Medical Exams (IME) and Peer Reviews. This opportunity allows you to customize... ...other healthcare professionals in compliance with state regulations and... ...Responsibilities: Reviews all medical records and addresses each question posed...Remote workFor contractorsMonday to Friday
$61.5k - $136.1k
...projects and evaluation of PCP/MG/IPA and HEDIS/QRS compliance with BCBSIL clinical practice... ...practice in the state of operations * Medical specialty certification (Certified Professional... ...Experience with HEDIS/QRS medical record review validation and/or experience with...Remote workHEDISFlexible hoursNight shift$54.92k - $107.1k
...of NCQA accreditation surveys and federal/state QI compliance activities. Knowledge / Skills / Abilities The Senior... ...metric data, including, but not limited to, HEDIS, STARS, etc., the analysis of medical records data, etc. Job Qualifications Required Education Bachelor...Remote jobHEDISWork experience placement- Stryker Corporation is seeking a Coder II in Eden Prairie, Minnesota to assign ICD-10-CM/PCS codes for inpatient encounters, ensuring compliance with coding guidelines. This role supports accurate reimbursement and data integrity for Powers Health hospitals. Applicants...Remote job
- ...offers a comprehensive range of medical services, including 24-hour... ...completeness of the medical record. Through concurrent interaction... ...medical records coding staff/compliance specialists, they facilitate... ...present on admission. Reviews quality of medical record documentation...Remote workPart timeRelocation package
- ...(Product, Operations, Compliance, and Engineering) to elicit... ...key features for the medical chart retrieval... ...solutions comply with HIPAA, HEDIS, and other relevant... ...plans, or medical records environments. Familiarity... ...salary with periodic reviews Remote-first work culture with...Remote workHEDISFlexible hours
- ...mandated turnaround times. Our reviewers are compensated on a per-case... ...an interpretation of the medical necessity of services provided... ...healthcare professionals in compliance with client-specific policies... ...Responsibilities Reviews all medical records and addresses each question...Remote workFor contractors
$89.17k - $142.68k
...and integrations to support HEDIS quality metrics, including strong... ..., Immunization Registry, Medical Records, FHIR APIs, and vendor... ...production cycles. Ensure compliance with HEDIS regulatory standards... ...you flexibility to work remotely with intentional in-person connection...Remote workHEDISWork at officeLocal areaFlexible hours2 days per week- ...Adjustment and Quality/HEDIS. Directs the daily... ...areas of risk adjustment, compliance, process improvement... ...potential of quality medical care and service. Serves... ...office visits and medical records reviews. Conducts specialized... ...Position Type: Remote Teaches / trains others...Remote workHEDISWork at officeLocal area
$52k - $83k
...Insurance Companies is seeking a fully remote Premium Audit Reviewer II in Nebraska. In this role, you will... ...audits for accuracy, ensuring compliance with guidelines and regulatory standards... ...communicate effectively. Benefits include medical, dental, and a 401k plan, with a...Remote work- ...CRA II - Sponsor Dedicated - Neurology... ...unique clinical, medical affairs and commercial... ...on-site or remotely) ensuring regulatory... ...GPP) and protocol compliance. Uses judgment and... ...Conducts Source Document Review of appropriate... ...documents and medical records. Verifies required...Remote workContract workInterim roleLocal areaImmediate startWork from homeFlexible hours
$38.92 - $60.33 per hour
...FROEDTERT HOSPITAL facility. This job is REMOTE. FTE: 1.000000 Standard Hours: 40.... ...and random audits of finalized inpatient medical records to assess the accuracy of DRG assignments. The auditor ensures compliance with documentation standards, accurate...Remote workHourly payTemporary workShift workWeekend work$198.22k - $297.33k
...Adjustment Data & Analytics (Remote) is a senior technical... ...suspecting, chart review, coding, submission,... ..., Data Governance and Compliance; establish and... ...partners to coordinate medical records access. Implementing coding... ...reporting requirements, HEDIS, STAR ratings,...Remote workHEDIS- ...Medical Coding Specialist Dallas, TX 8hr shift... ...inpatient hospital coding compliance or coding auditing... ...requirements HEDIS measures CAT II code reporting for HTN... ...and cervical cancer Review NCCI and nosology edits... ...Evaluate medical record for provider signature...HEDISShift work
- A healthcare provider for children in Texas is seeking an HIM Coder Analyst II to accurately code medical records, ensuring compliance with ICD-10-CM and CPT guidelines. This role requires attention to detail and collaboration with healthcare professionals to improve documentation...Remote job
- ...Austin, TX is seeking a Quality Program Strategist II to oversee quality improvement initiatives. This remote position requires a Bachelor's degree and at least... ..., manage stakeholder relationships, and ensure compliance to improve healthcare quality. Centene offers a comprehensive...Remote jobHEDISFlexible hours
$22.22 - $31.71 per hour
...seeking a Coding Specialist II to ensure proper coding compliance and documentation accuracy... ...2-3 years' experience in medical coding and an in-depth... ...codes. This position is fully remote, with a pay range of $22.2... ...include analyzing medical records and ensuring coding...Remote jobHourly pay- ...Insurance Companies is hiring a fully remote Premium Audit Reviewer II in New Jersey. The successful... ...reviews of premium audits and ensure compliance with regulations. Key qualifications... ...handling audit inquiries. Benefits include medical, dental, vision insurance, a 401k...Remote job
$52k - $83k
CopperPoint Insurance Companies is offering a fully remote position for a Premium Audit Reviewer II. The role requires reviewing and evaluating premium audits for compliance with company standards. Ideal candidates should have strong analytical skills, at least 2 years...Remote job
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