Data Abstractor - Quality

UPMC; Jamestown (NY); Sur place; USD 42 000 - 64 000; Plein temps

Résumé du poste

UPMC in Jamestown, NY seeks a Data Abstractor to support value-based care by reviewing medical records, identifying care gaps, and coordinating with clinicians. The role offers a Monday through Friday schedule, typically 8:00am to 4:30pm, with quarterly travel to Erie, PA. No evenings or weekends required.

The ideal candidate has strong Excel skills, healthcare experience, and familiarity with EMRs and CMS guidelines to ensure complete and accurate medical records for audits and reimbursement.

Qualifications

• Healthcare experience preferred
• Familiarity with HEDIS, preventive care measures, and value based care programs strongly preferred
• Knowledge of HCC/risk adjustment concepts beneficial
• Strong Excel skills required
• Strong critical-thinking and problem-solving abilities
• Excellent organizational and communication skills
• Ability to adapt to changing healthcare regulations, payer requirements, and quality initiatives
• Experience with EMRs and medical records preferred
• Comfortable performing patient outreach and working independently

Responsabilités

• Conveys courtesy and positive attitude while supporting department goals
• Analyses and monitors electronic medical records and identifies required documentation
• Maintains and submits weekly a Daily Productivity Log
• Adapts to changes and prioritizes work with supervision
• Reviews PHC4 Error Report and maintains CMS data accuracy
• Maintains knowledge of CMS/Core Measure Specifications and AHA/GWTG Stroke specifications
• Adheres to productivity standards and communicates barriers
• Attends department and system meetings and webinars
• Reviews clinical documentation and extracts data according to CMS specifications
• Participates in training of new employees
• Balances team and individual responsibilities to build team spirit
• Maintains 80 percent stroke accuracy rate for audits
• Assesses electronic data sources and evaluates software performance

Connaissances

Healthcare experience

HEDIS

HCC/risk adjustment concepts

Excel

Analytical skills

Attention to detail

Communication skills

Adaptability

EMRs

Organization

Independent work

Outils

MARS

Medipac

Cerner

HPF

Description du poste

UPMC'S GLPP outpatient group is seeking a Data Abstractor to join their team! This full-time position will work Monday through Friday, typically between the hours of 8:00am and 4:30pm. The primary location for this role is based in Jamestown, NY. Travel to Erie, PA may be required quarterly, depending on department needs. No holidays, evenings or weekends are required. This role is much more than traditional data abstraction. The individual will actively support value-based care programs by reviewing patient records, identifying care gaps, performing patient outreach, coordinating with physician offices and clinical staff, obtaining outside diagnostic reports, and ensuring complete and accurate medical records. The position requires a strong balance of analytical skills, attention to detail, communication skills, and adaptability. Candidates with the following experience or background are encouraged to apply:

• Healthcare experience preferred
• Familiarity with HEDIS, preventive care measures, and value-based care programs strongly preferred
• Knowledge of HCC/risk adjustment concepts beneficial
• Strong Excel skills required
• Strong critical-thinking and problem-solving abilities
• Excellent organizational and communication skills
• Ability to adapt to changing healthcare regulations, payer requirements, and quality initiatives
• Experience with EMRs and medical records preferred
• Comfortable performing patient outreach and working independently

Responsibilities:

• Demonstrates a service-oriented approach to the position by conveying courtesy, respect, enthusiasm and positive attitude for work responsibilities. Show initiative and offer assistance to all department customers and UPMC Health System personnel in the completion of the department's goals. Patient care issues and inter-departmental service are the first priority as a staff member while protecting confidentiality of all patient related information.
• Analyzes and monitors the electronic medical record and identifies the required medical and/or surgical documentation through various electronic systems: MARS, Medipac, Cerner, HPF, etc., where/if applicable. Recognizes and reports discrepancies found in the medical record to alert upstream and downstream users as appropriate. (i.e.: Registration, coding, information systems)
• Maintains and submits weekly a Daily Productivity Log of activities to the Coordinator/Manager.
• Adapts to changes in the work environment and process change, as necessary, and be able to prioritize work with the assistance of the Data Validation Coordinator, Supervisor, Manager or Director.
• Reviews, edits/completes PHC4 Error Report as per their Director, Manager, or Data Validation Coordinator.
• Maintains a strong knowledge base of the CMS/Core Measure Specifications with each year's new version through continuous maintenance of the glossary, webinars, and continuous education for both Inpatient & Outpatient data collection. Maintains a strong knowledge of the current AHA/GWTG's Stroke Specifications for Primary Stroke Center facilities.
• Adhere to department productivity standards. Communicate any barriers affecting expected standards and work collaboratively with supervisory team to meet department abstraction goals.
• Attends UPMC Departmental and System meetings, training/educational webinars as required.
• Reviews clinical documentation and extracts the key data elements according to rules and regulations as defined in the CMS/Centers for Medicare and Medicaid Specifications Manual . 100% accuracy of this CMS data is critical since the information is directly related to reimbursement for VBP/Value Based Purchasing and full APU reimbursement in regard to quarterly CDAC Audits as applicable
• Participate in training and orientation of new employees in regards to the electronic record, clinical documentation, abstraction guidelines, and validation processes.
• Balance team and individual responsibilities while contributing to building a positive team spirit.
• As required by The Joint Commission, maintains an 80% Stroke accuracy rate for internal bi-annual validation audits through applied abstraction skills within the AHA/GWTG Stroke Registry.
• Reviews clinical documentation and extracts key data elements according to the AHA/GWTG's Specifications Rules and Regulations to maintain certification for Primary Stroke Centers. As required by The Joint Commission, maintains an 80% Stroke accuracy rate for internal bi-annual validation audits through applied abstraction skills within the AHA/GWTG Stroke Registry.
• Participates in ongoing assessment of the electronic data sources. Evaluate data abstraction software performance to detect potential system issues.