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Hedis Chart Jobs in Indiana (NOW HIRING)

STI

ADDM Abstractor

Indianapolis, IN · On-site

Responsibilities include, but are not limited to the following: 1. 1. This position will work remotely to complete medical chart abstractions on children reported to the ADDM network. 1. 2. Actively ...

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Hedis Chart information

What is the difference between Hedis Chart vs Medical Coder?

AspectHedis ChartMedical Coder
CredentialsTypically requires knowledge of HEDIS measures, healthcare documentation, and coding standardsRequires coding certifications like CPC, CCS, or CCS-P
Work EnvironmentHealthcare facilities, insurance companies, or consulting firmsHospitals, clinics, insurance companies, or coding service providers
Industry UsageUsed for quality measurement and healthcare reportingUsed for medical record coding and billing
Primary FocusChart review for HEDIS compliance and quality metricsAccurate medical record coding for billing and documentation

The main difference between a Hedis Chart specialist and a Medical Coder lies in their focus. Hedis Chart professionals concentrate on reviewing healthcare charts to ensure compliance with HEDIS quality measures, while Medical Coders focus on translating medical records into standardized codes for billing and documentation. Both roles require healthcare knowledge, but their specific tasks and certifications differ.

What are HEDIS chart abstractors?

HEDIS chart abstractors are healthcare professionals who review and extract clinical information from patient medical records to support the Healthcare Effectiveness Data and Information Set (HEDIS) reporting process. Their work helps healthcare organizations measure and report on the quality of care provided to patients, ensuring compliance with national standards set by the National Committee for Quality Assurance (NCQA). HEDIS chart abstractors typically need a strong understanding of medical terminology, medical records, and quality measurement requirements. Their efforts directly impact a health plan’s quality scores and reputation.

What are some common challenges faced by professionals working in HEDIS chart abstraction, and how can they be addressed?

Professionals in HEDIS chart abstraction often encounter challenges such as incomplete or inconsistent medical records, tight reporting deadlines, and the need to navigate various electronic health record (EHR) systems. To address these issues, it helps to develop strong attention to detail, effective time management skills, and familiarity with multiple EHR platforms. Collaborating closely with healthcare providers and team members can also improve data accuracy and streamline the abstraction process.

What are the key skills and qualifications needed to thrive as a HEDIS Chart Abstractor, and why are they important?

To thrive as a HEDIS Chart Abstractor, you need a background in healthcare, strong knowledge of HEDIS measures, and experience with medical record review, often supported by a nursing or health information degree. Familiarity with electronic health record (EHR) systems, chart abstraction tools, and HEDIS-specific software like NCQA's tools is typically required. Attention to detail, analytical thinking, and strong organizational skills are essential soft skills for this role. These skills ensure accurate data collection and reporting, which are critical for healthcare quality improvement and compliance.
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What cities in Indiana are hiring for Hedis Chart jobs? Cities in Indiana with the most Hedis Chart job openings:
Hedis Chart jobs near you

Certified Medical Assistant - Clinical Quality Specialist

SIHO HOLDING INC

Indianapolis, IN • On-site, Remote

$35 - $46.50/hr

Other

Posted 7 days ago

Job description

Job Title: CMA - Clinical Quality Specialist 

Reports to: Director, Medical Management 
**Not open to remote, qualified candidates must reside in Indianapolis, IN

The Clinical Quality Specialist supports the Clinical Quality Nurse in overseeing the HEDIS quality collection, submission, reporting, and auditing as well as assists with education to support the MyTruAdvantage line of business. 

Key Responsibilities: 

  • Knowledge of current HEDIS guidance, hybrid measure reporting, and measure compliance requirements.  

  • Collaborate with Clinical Quality Nurse and internal data analyst to oversee HEDIS quality gap distribution to health partners and member providers for HEDIS clinical data collection. 

  • Participate in communication with health partners regarding process of clinical document submission, annual education on applicable HEDIS measures, and cadence of reporting.  

  • Help identify opportunities for improved or expanded HEDIS data collection.  

  • Participate in internal chart chasing efforts.  

  • Assure proper internal secure storage of HEDIS data collected from external providers. 

  • Participate in Medical Record Review clinical submissions processes, assuring accuracy and completeness. 

  • Support outreach efforts to external providers to collect clinicals needed for reporting. 

  • Assist with maintaining all HEDIS related guidelines, policy & procedures, and auditing documents necessary for successful annual HEDIS audits. 

  • Active participant in any external HEDIS audits performed as needed.  

  • Support internal Chronic Care Improvement Program initiatives as needed. 

  • Participate in internal or external process improvement efforts that support the quality improvement and collection efforts necessary for the Medicare Advantage or commercial lines of business. (Accurate provider attributions, training of health partners, training of new internal staff etc.) 

Minimum Skills Requirement:

  • CMA or experience in clinical documentation review preferred.

  • Experience in working for or with HEDIS data collection and reporting preferred.

  • Proficiency in Microsoft Office Suite (Outlook, Word, Excel, PowerPoint).

  • Experience with electronic medical records and using online tools.

  • Ability to communicate professionally with physicians and office staff to facilitate organizational initiatives.

  • Willingness to obtain applicable HEDIS certifications deemed appropriate for position.

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