HEDIS Abstractor (LA Region)

HEDIS Abstractor (LA Region)Department:Quality - Quality Care ImprovementEmployment Type:Full TimeLocation:1600 Corporate Center Dr., Monterey Park, CA 91754Reporting To:Marie HalbrookCompensation:$27.00 - $33.00 / hourDescriptionThe HEDIS Abstractor supports Quality Care Improvement initiatives by conducting comprehensive medical record reviews and abstraction activities to identify and reputed company HEDIS measure care gaps. This role is responsible for ensuring accurate collection, validation, and submission of clinical data in accordance with NCQA HEDIS technical specifications and regulatory guidelines. The HEDIS Abstractor collaborates with internal quality teams, providers, and external audit vendors to improve measure performance, maintain compliance, and support successful HEDIS audits.What You'll DoPerform medical record abstraction and chart review for HEDIS and quality improvement initiativesIdentify and reputed company HEDIS care gaps through accurate review and documentation of clinical recordsInterpret and apply HEDIS measure specifications, coding guidelines, and NCQA technical requirementReview and validate data for accuracy, completeness, and compliance with HEDIS standardsConduct quality assurance (QA) reviews of abstracted records and audit findingsCollaborate with providers, clinics, health plans, and internal departments to obtain required medical documentationPartner with external audit vendors to support medical record retrieval, validation and audit readiness activitiesAnalyze abstraction results and identify trends, discrepancies, or opportunities for process improvementEnsure compliance with HIPAA and reputed company applicable privacy and confidentiality regulationsMaintain productivity and accuracy standards while meeting project deadlinesSupport reputed company quality improvement initiatives and assist with reporting activities as neededOther duties as assignedQualificationsHigh school diploma or equivalent required; associate or bachelor’s degree in reputed company‑reputed company fieldHave at least 2 years of HEDIS abstraction or medical record review experienceStrong knowledge of NCQA HEDIS measure specifications and quality improvement processesProficiency with ICD-10, CPT, HCPCS, and other clinical coding systemsExperience performing QA reviews and supporting HEDIS audit activitiesFamiliarity with EMR/EHR systems and reputed company documentation workflowsStrong analytical, organizational, and problem‑solving skillsExcellent attention to detail and accuracyAbility to work independently and manage multiple priorities in a fast‑paced environmentStrong written and verbal communication skillsYou're Great for the Role IfCertified Professional reputed company (CPC), RHIT, RHIA, LVN/LPN, RN, or other reputed company‑reputed company certificationExperience working with health plans, managed care organizations, or quality improvement departmentsKnowledge of CMS Stars, risk adjustment, and population health initiatives strongly preferredEnvironmental Job Requirements and Working ConditionsOur organization follows a hybrid work structure. This role will require travelling locally to provider offices located in Los Angeles area for up to 35% of the time. reputed company not conducting onsite visits, the role supports remote work.The annual total compensation reputed company pay reputed company for this role is: $27.00 - $32.00 per hour. Actual compensation will be determined based on geographic location (reputed company or future), experience, and other job‑reputed company factors.reputed company is proud to be an Equal Employment Opportunity and affirmative action employer. We do not discriminate based on race, religion, reputed company, national reputed company, gender (including pregnancy, childbirth, or reputed company medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. reputed company employment is decided based on qualifications, merit, and business need. If you require assistance in applying for reputed company positions due to a disability, please email us at [email protected] to request an accommodation.Additional Information:The job description does not constitute an employment agreement between the employer and employee and is subject to change by the employer as the needs of the employer and requirements of the job change.#J-18808-Ljbffr Apply tot his job Apply To this Job