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Hedis Remote Chart Review Jobs in Massachusetts (NOW HIRING)

US Tech Solutions

Medical Billing Coder

Wellesley, MA · Remote

$20.50 - $27.50/hr

... on-site, remote and/or in-house) in support of the Medicare risk adjustment retrospective ... This role will also assist with building the medical chart review program at Client's Duties and ...

UnitedHealth Group

Customer Service Representative

Auburn, MA · Remote

$16 - $21.75/hr

This includes chart review to identify previous activity that may have occurred related to the call ... in a remote environment. * Complies with health and safety requirements and with regulatory ...

Care Access

Provider Partnership Liaison

Boston, MA · Remote

$80K - $110K/yr

... Chart Review when necessary. * Pursue qualified opportunities to close; meet or exceed quota ... This is a remote position with up to up to 50% travel requirements for appropriate customer ...

UnitedHealth Group

Pharmacy Care Coordinator

Norwood, MA · Remote

$21.25 - $27.75/hr

REMOTE IN MA Optum is a global organization that delivers care, aided by technology to help ... Gathers all necessary information from chart review and identifies correct forms needed to submit ...

Dana-Farber Cancer Institute

The Research Data Specialist will perform chart review in Epic, collect relevant data points, and ... This position's work location is fully remote with occasional time on-campus in [enter location]

Essen Health Care

Medical Director Physician

Boston, MA · Remote

$350K/yr

... remote monitoring, and real-time support for caregivers. Our clinical programs are designed to ... chart reviews to monitor quality and consistency of clinical care Quality and Performance ...

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Hedis Remote Chart Review information

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

To thrive as a HEDIS Remote Chart Reviewer, you need a solid understanding of medical terminology, healthcare coding (ICD-10, CPT), and HEDIS measures, often supported by a clinical background such as nursing or health information management. Proficiency with electronic medical records (EMRs), chart abstraction tools, and secure remote work platforms is typical, and experience with HEDIS-specific software is highly valued. Attention to detail, time management, and strong written communication are crucial soft skills for ensuring accurate data extraction and reporting. These competencies ensure high-quality, compliant chart reviews that contribute to healthcare quality initiatives and regulatory reporting.

What are some common challenges faced by professionals in a HEDIS Remote Chart Review role, and how can they be addressed?

Professionals in HEDIS Remote Chart Review often encounter challenges such as inconsistent documentation in medical records, navigating various electronic health record (EHR) systems, and ensuring data accuracy while working independently. Addressing these challenges involves developing strong attention to detail, leveraging organizational tools to track reviewed charts, and maintaining open communication with team leads and colleagues for clarification or support. Regular training on EHR systems and HEDIS measures can also help reviewers stay current and efficient in their work.

What is a HEDIS Remote Chart Reviewer?

A HEDIS Remote Chart Reviewer is a healthcare professional who reviews medical records from a remote location to collect data for the Healthcare Effectiveness Data and Information Set (HEDIS). This data is used by health plans to measure performance on important dimensions of care and service. Reviewers look for specific information in patient charts to ensure health plans meet quality standards and regulatory requirements. The job typically requires experience in medical record abstraction, knowledge of HEDIS measures, and strong attention to detail.

What is the difference between Hedis Remote Chart Review vs Medical Records Reviewer?

AspectHedis Remote Chart ReviewMedical Records Reviewer
CredentialsTypically requires nursing or healthcare-related certificationsOften requires medical or healthcare background, certifications vary
Work EnvironmentRemote, independent review of patient chartsRemote or onsite review of medical records
Industry UsageUsed mainly in healthcare quality and compliance programsUsed across healthcare, insurance, and legal sectors

Hedis Remote Chart Review and Medical Records Reviewer roles both involve reviewing medical records remotely, often requiring healthcare certifications. However, Hedis reviews focus specifically on healthcare quality metrics for Medicaid and Medicare, while Medical Records Reviewers may work in broader contexts like insurance claims or legal cases. Both roles demand attention to detail and healthcare knowledge, but Hedis reviews are more specialized in compliance and quality measurement.

What are popular job titles related to Hedis Remote Chart Review jobs in Massachusetts? For Hedis Remote Chart Review jobs in Massachusetts, the most frequently searched job titles are:
What job categories do people searching Hedis Remote Chart Review jobs in Massachusetts look for? The top searched job categories for Hedis Remote Chart Review jobs in Massachusetts are:
What cities in Massachusetts are hiring for Hedis Remote Chart Review jobs? Cities in Massachusetts with the most Hedis Remote Chart Review job openings:
Hedis Remote Chart Review jobs near you
Medical Billing Coder

Medical Billing Coder

US Tech Solutions

Wellesley, MA • Remote

$20.50 - $27.50/hr

Full-time

Posted 14 hours ago

Job description

Company Description

US Tech Solutions is a global staff augmentation firm providing a wide-range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit our website www.ustechsolutions.com.

We are constantly on the lookout for professionals to fulfill the staffing needs of our clients, sets the correct expectation and thus becomes an accelerator in the mutual growth of the individual and the organization as well.

Keeping the same intent in mind, we would like you to consider the job opening with US Tech Solutions that fits your expertise and skillset.

Job Description

Medical Record Reviewer will primarily be responsible for completing medical record reviews (on-site, remote and/or in-house) in support of the Medicare risk adjustment retrospective initiative and Risk Adjustment Data Validation (RADV) Audits. This role will also assist with building the medical chart review program at Client's

Duties and Responsibilities

  • Utilize comprehensive knowledge American Hospital Association (AHA) coding principles of CPT, HCPCS, ICD9-CM/ICD10-CM diagnosis and procedure codes to evaluate medical record documentation for HCC risk adjustment related activities including Medicare Advantage and Commercial Risk adjustment supplemental diagnosis capture, Medicare and Commercial RADV support, and the auditing of Client's medical chart retrieval and coding vendors.
  • Collect and document chart and coding information as required for Commercial Risk Adjustment and Medicare Advantage Risk Adjustment Client's data collection procedures and systems. 
  • Assist with building the medical chart review program at Client's including defining the operating policies and procedures, mentoring team members and input into infrastructure needs and organization. 
  • Utilize coding expertise to inform Revenue Management strategy development activities and may support initiatives related to coding such as provider office education.
  • Responsible for developing and maintaining internal and vendor based coding guidelines.
  • Provide subject matter expertise on projects related to coding practices including provider education and communications.
  • Prepare reports of the data gathered and received from Client's providers/members, ensuring reports are completed with the highest quality and integrity and that all work is in full compliance with Client's and Regulatory requirements.
  • Participate in all required training - maintaining of coding certification or other professional credentials
  • Completing inter-rater reliability testing as requested 
  • Abide by all HIPAA and associated patient confidentiality requirements.
  • Coordinate with third party and internal auditors as required.
  • Other duties and projects as needed.
Qualifications

Minimum Requirements

  1. Bachelor's Degree; Clinical experience or licensed nursing professional and 3-5 years related experience. RHIA, RHIT, CCS or CPC-H with demonstrated outpatient coding experience required. ICD -9/ICD-10 certification required. 
  2. Experience in performing HEDIS chart abstractions; Experience in Risk Adjustment audit HCC extraction.
  3. Experience of healthcare delivery systems is preferred. Proven project leadership skills and ability to mentor and motivate others in the team. 
  4.  Advanced PC skills (e.g., Excel, Access, etc.) required; Excellent written and verbal communication skills, customer service skills, organization and problem solving skills, research skills, and the ability to work independently.
Additional Information

Thanks & Regards

Dishant

781-684-9064

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About US Tech Solutions

Sourced by ZipRecruiter

US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions.

Industry

It services

Company size

1,001 - 5,000 Employees

Headquarters location

Jersey City, NJ, US

Year founded

2000

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