*HEDIS Reviewer II at Conflux Systems Alabama

🌍 Remote, USA 💹 Full-time 🕐 Posted Recently

Job Description

Job Title: HEDIS Reviewer II

Duration: 5 Months Contract (Potential for extension)

Location: Remote

Shift Hours: Monday thru Friday, 8 hours worked, between the hours of 8am and 5pm local time

Start date: 01/05/2026

Participates in the collection and review of medical records to abstract clinical information for HEDIS quality reporting.
Training will be provided prior to the start of the assignment.
May be selected to do an onsite visit to a provider’s office to collect medical records, only as needed.

This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS and CMS performance measures.
Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements.
Requires proficiency with databases and conducting all work activities on the computer.
Must commit to the duration of the project with the understanding that work hours can vary.
Due to proprietary information, must inform employer if planning to accept employment with another company.

Complete assigned abstraction and data entry each day.
Work with provider offices as needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters.
Locate and review all assigned medical charts, perform abstraction, copy all supporting documentation per specifications, and data enter into the applicable software system.
Prioritize and accurately complete tasks within established times.
Identify trends and document areas for improvement.
Maintain project productivity levels while maintaining accuracy requirements for abstraction and data entry activities.

Experience with collection and review of medical records for HEDIS quality reporting.
Proficiency in using Adobe PDF for annotations and in populating data collection tools.
Strong database skills and ability to conduct 100% of work activities on computer.
Demonstrated ability to meet deadlines and maintain high accuracy in data abstraction.

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