HEDIS Chart Abstractor / Measure Validator (seasonal)

VERDA HEALTHCARE; Huntington Beach (CA); On-site; USD 39,000 - 44,000; Full time

Job summary

Verda Healthcare, Inc. in Huntington Beach, CA is seeking a seasonal HEDIS Chart Abstractor/Measure Validator to review and validate clinical data for NCQA measures.

The role requires chart abstraction and data entry within HEDIS software, with HIPAA-compliant handling of PHI and inter-rater reliability testing. The position is full-time onsite with standard hours, offering an hourly compensation range of $28-$32.

Qualifications

• Minimum of 1–2 years of direct experience with HEDIS chart abstraction, medical record auditing, or clinical quality measurement.
• Deep understanding of NCQA HEDIS technical specifications and coding standards.
• Hands-on experience with major EMR systems and HEDIS software platforms.

Responsibilities

• Medical Record Review & Abstraction: Access and review EMR or paper charts to locate documentation for HEDIS measures.
• Measure Validation: Validate abstracted data against NCQA HEDIS specifications for accuracy.
• Data Entry & Documentation: Enter abstracted data into internal HEDIS software or data systems.
• Quality Assurance: Participate in IRR testing to maintain consistency and quality across the team.
• Provider Outreach: Collaborate with provider offices to request missing chart components.
• Compliance Tracking: Adhere to HIPAA and privacy standards and PHI handling protocols.
• Issue Resolution: Escalate discrepancies or errors to Quality Improvement leadership.

Skills

Strong analytical skills

Exceptional attention to detail

Independent work

Education

RN, LPN/LVN, RHIA, RHIT, CPHQ, or CPC

Tools

Epic

Cerner

Allscripts

Cotiviti

Inovalon

Inovalon QSI

Job description

Description

Verda Healthcare, Inc. is a Medicare Advantage Prescriptions Drug Plan (MAPD) organization committed to the idea that healthcare should be easily and equitably accessed by all, currently available in Texas and Arizona. Our mission is to ensure that underserved communities have access to health and wellness services, and receive the support needed to live a healthy life that is free of worry and full of joy. We are looking for a HEDIS Chart Abstractor / Measure Validator (seasonal) to join our growing company with many internal opportunities.

Are you ready to join a company that is changing the face of health care across the nation? Verda Healthcare, Inc. is looking for people like you who value excellence, integrity, care and innovation. As an employee, you’ll join a team dedicated to improving the lives of our Medicare members. Our vision incorporates value-based health care that works. We value diversity.

Align your career goals with Verda Healthcare, Inc. and we will support you all the way.

Position Summary

The HEDIS Chart Abstractor/Measure Validator (seasonal) is responsible for reviewing, abstracting, and validating clinical data from medical records to support Healthcare Effectiveness Data and Information Set (HEDIS) reporting. This role ensures compliance with National Committee for Quality Assurance (NCQA) guidelines by auditing charts for accuracy, identifying gaps in care, and validating that specific clinical measures are met.

Key Responsibilities

• Medical Record Review & Abstraction: Access and review electronic medical records (EMR) or paper charts across various provider networks to locate specific clinical documentation required for HEDIS measures.
• Measure Validation: Validate abstracted data against NCQA HEDIS specifications to ensure high data integrity and accuracy.
• Data Entry & Documentation: Accurately enter abstracted clinical data into internal HEDIS software or designated data management systems.
• Quality Assurance: Participate in inter-rater reliability (IRR) testing to maintain consistency and quality control standardizations across the abstraction team.
• Provider Outreach: Collaborate with provider offices, clinics, and hospitals to request and retrieve missing medical chart components when necessary.
• Compliance Tracking: Maintain strict adherence to HIPAA regulations, privacy standards, and company protocols regarding the handling of Protected Health Information (PHI).
• Issue Resolution: Identify and escalation document discrepancies, systemic data entry errors, or charting trends to the Quality Improvement leadership team.

Verda cares deeply about the future, growth, and well-being of its employees. Join our team today!

Job Type: Full-time seasonal employment

Location: Huntington Beach, CA

Compensation Range: $28-32 hourly

Schedule:

• Full-time onsite (100% in-office)
• Hours of operations: 9am – 6pm
• Standard business hours Monday to Friday
• Occasional travel may be required for meetings and training sessions.

Ability to commute/relocate: Reliably commute or planning to relocate before starting work (Required)

PHYSICAL DEMANDS

Regularly sit/walk at a workstation in an office or cubicle setting. Must occasionally lift and/or move up to 25-50 pounds.

*Other duties may be assigned in support of departmental goals.

Requirements

• Licensure/Certification (Preferred): Active RN, LPN/LVN, RHIA, RHIT, or Certified Professional in Healthcare Quality (CPHQ), or CPC
• Experience: Minimum of 1–2 years of direct experience with HEDIS chart abstraction, medical record auditing, or clinical quality measurement.
• Technical Proficiency: Hands-on experience with major EMR systems (e.g., Epic, Cerner, Allscripts) and specialized HEDIS software platforms (e.g., Cotiviti, Inovalon, Inovalon QSI).
• Knowledge Base: Deep understanding of NCQA HEDIS technical specifications, medical terminology, ICD-10, CPT, and HCPCS coding standardizations.
• Core Competencies: Strong analytical skills, exceptional attention to detail, and the ability to work independently in a deadline-driven environment.