*HEDIS Reviewer II

A-Line Staffing Solutions; Woonsocket (RI); Hybrid; USD 42,000 - 52,000; Full time

Job summary

A-Line Staffing Solutions is seeking a HEDIS Reviewer II. The role involves reviewing and abstracting medical records to support HEDIS quality reporting and CMS performance measures. You will locate charts, abstract clinical data, and ensure documentation accuracy while coordinating with provider offices for submissions.

Remote work is available with potential onsite visits. Typical hours are Monday to Friday, 8:00 am–5:00 pm local time, with travel as needed and adherence to PHI/HIPAA

Qualifications

• High School Diploma or GED required, medical knowledge helpful.
• Strong communication, organization and attention to detail are essential.
• Experience with medical record auditing/abstraction preferred (1–3 seasons).
• Proficiency in Word, Excel, Adobe Reader and email communication.

Responsibilities

• Review and abstract medical records to support HEDIS quality reporting and CMS measures.
• Locate and review assigned charts; abstract clinical information and ensure documentation completeness.
• Enter data accurately in software systems and coordinate with provider offices for submissions.
• Handle calls, assist with scheduling and follow-ups; may travel to provider offices as needed.
• Maintain productivity while upholding accuracy and confidentiality of PHI/HIPAA.

Skills

Excellent communication

Organization

Attention to detail

Education

High School Diploma or GED

Medical terminology knowledge

Tools

Microsoft Word

Excel

Adobe Reader

Job description

Job Title: HEDIS Reviewer II Address: City, State Job Description: Participates in reviewing and abstracting medical records to support HEDIS quality reporting and CMS performance measures.

Locates and reviews assigned medical charts, abstracts clinical information, and copies supporting documentation. Uses software systems for data entry, ensuring accuracy and completeness of documentation. Coordinates with provider offices for appointment scheduling, record submissions, and follow-ups. Maintains productivity while adhering to accuracy standards in data abstraction and entry. Handles incoming calls and reroutes return mail as needed. Participates in training and may travel to provider offices for record collection.

Critical Information:

Remote work with potential onsite visits to provider offices. Monday through Friday, 8:00 am - 5:00 pm local time.

Ability to connect to the internet via ethernet cable. Work involves handling equipment up to 20 lbs. Reliability in transportation for occasional travel. Work is primarily computer-based, involving databases, Adobe PDF, and Office Suite tools.

Compliance with confidentiality and security protocols for PHI and HIPAA.

Education / Licenses Needed:

High School Diploma or GED. Medical knowledge and terminology required. Experience in medical record auditing and abstraction (1-3 seasons). Proficiency in Microsoft Word, Excel, email, Adobe Reader. Excellent communication, organization, and attention to detail.