Equivalent Experience
Looking to hire LVN’s (or RN’s) to work remotely for Blue Shield, CA in support of the HEDIS Medical Record Review Cycle .
Candidates may sit anywhere in California!!
Description / Job Duties: Medical Record Review Abstractor
Perform medical record abstraction and enter findings into Database.
Identify Pursuit Opportunities & Track progress.
Call provider offices & hospitals to request medical records.
Call members to identify date & provider of HEDIS service.
Data enter call results in Pursuit Database.
Coordinate with Collector and manage caseload.
Communicate with team members to effectively manage project assignment.
Day to Day Responsibilities of this Position and Description of Project:
This position will be in support of the HEDIS Medical Record Review (MRR) cycle.
The individuals will work directly with HEDIS MRR Program Manager and other medical record reviewers to review medical record.
Primary responsibility will be to perform medical record review, enter findings into abstraction tool (Inovalon QSHR), and to over read
Identify chase opportunities & track progress
Coordinate with Program Manager, and administrative staff to manage caseload for teams
Communicate with team members to effectively manage project assignment
Qualifications :
LVN or RN Licensing (Required)
Additional Skills & Qualifications:
HEDIS experience is highly preferred
Experience Level:
Expert Level
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