HEDIS Reviewer II [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 measures. Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements. The candidate must be proficient with databases and with conducting 100% of work activities on the computer.

Skills:

• Medical knowledge/terminology is required.
• Knowledge of HEDIS and reviewing medical records is required.
• Ability to read and interpret medical records.
• Excellent verbal and written communication skills – clear, concise and appropriate.
• Computer savvy: Microsoft Word, Excel, email, and Adobe reader (if applicable) required. Know how to save a file to a folder.

Education/Experience:

• Verifiable High School Diploma or GED is required