Hedis Nurse Abstractor

SUMMARY

- The HEDIS Abstractor reviews medical records to ensure completeness, compliance with NCQA, DHS, MRMIB and other regulatory agencies.
- Abstracts medical record information and enters data on appropriate HEDIS forms (tool).
- Makes determinations on records and refers records to supervisor for clarification when needed.
- Conducts audits at provider offices and provides feedback to office staff, provider on documentation and medical record coding.
- All received medical record information is abstracted and entered accurately on HEDIS forms.
- Demonstrated ability to abstract a average of 35-50 records or more per day for multiple measures.
- Must be able to work with other staff members to complete the HEDIS project within the time frame for submission to the auditor, NCQA, and regulatory agencies.
- Works with schedulers to help them better understand the medical record requests.
- In addition, the nurse abstractor speaks with the office staff/manager/provider to clarify the medical record request.

SKILLS:

Skills/Qualificaitons:

- AA in Health Sciences, Nursing, Health Information systems
- Strong background in medical terminology, anatomy and physiology