[Hiring] HEDIS Medical Record Analyst @Cambia Health Solutions

Role Description

The HEDIS Medical Record Analyst’s primary responsibilities will be to retrieve, abstract, or over read medical records in order to capture pertinent, required data elements for HEDIS reporting. The core responsibilities of this role may include but are not limited to:

• Collecting member medical records from various electronic medical record (EMR/EHR) systems.
• Performing reviews of electronic medical records to determine if required documentation is present.
• Downloading medical record images to one of our corporate drives.
• Logging receipt of medical record documentation in appropriate software.
• Retrieval efforts may also include pursuit via phone call, fax, mail, or direct onsite pickup.
• Abstract and/or over read all pertinent medical record data and enter it into a specified HEDIS database to support HEDIS reporting and Quality Improvement.
• Over reading of medical records that have been abstracted by other HEDIS Medical Record Analysts.

Responsibilities:

• Collects assigned medical records from EMR/EHR systems and prepares them for medical record abstraction.
• Documents retrieval progress/findings for each EMR accessed.
• Communicates effectively and professionally with provider offices.
• Reviews assigned medical records in order to abstract specified clinical data elements for HEDIS reporting (e.g. date of service of breast cancer screening, date of service and results of laboratory tests related to chronic conditions).
• Documents abstraction findings on appropriate paper and/or electronic tools as directed by the HEDIS MR Team.
• Communicates additional pursuit strategies, if needed, to other members of the team as defined in the department’s policies and procedures.

Qualifications

• Excellent interpersonal skills and ability to work effectively in team environment.
• Demonstrated command of medical terminology, navigating EMR/EHR systems, medical record documentation, and clinical processes.
• Demonstrated problem solving ability.
• Knowledge of Microsoft office products desirable.
• Understanding of HIPAA.
• Knowledge of ICD-9 and 10-CM, CPT, HCPCS and DRG coding conventions a plus.
• Knowledge of FACETS a plus.
• Experience with quality oversight and teaching desired.
• Prior experience in HEDIS and medical record retrieval and/or abstraction for quality or research projects.

Requirements

• Normally to be proficient in the competencies listed above, HEDIS Medical Record Analysts would have an Associate degree in Nursing or related field and 3 years of experience in a clinical setting, working with medical records, and/or experience with EMR/EHR systems or equivalent combination of education and experience.
• One of the following is preferred:
  • Valid Registered Nursing (RN/LVN/LPN)
  • CPC – Certified Professional Coder
  • CCS - Certified Coding Specialist

Benefits

• The base pay range for this temporary role is $41.00-$48.00 an hour DOE.
• This is a non-benefited role.