Medical Review Nurse (HEDIS)
Cynet Systems
The Clinical Medical Review Specialist supports HEDIS quality initiatives by retrieving, reviewing, and accurately abstracting medical records in accordance with NCQA specifications. The role involves using proprietary tools and software to conduct medical record reviews, coordinating with healthcare provider offices to obtain records and verify contact information, following up on retrieval requests, and escalating issues as needed. The specialist must maintain strict compliance with HIPAA privacy and security standards while supporting the Quality Team in medical record retrieval and review activities.
Vacancy posted 2 days ago
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