Remote HEDIS Review Nurse - Accurate Abstractions

Spectraforce Technologies; Raleigh (NC); On-site; USD 55,000 - 85,000; Full time

Job summary

Spectraforce Technologies is seeking a RN or LPN for a remote HEDIS Review Nurse assignment of 4+ months. You will perform medical record abstractions and overreads for the annual NCQA HEDIS survey, following NCQA guidelines and technical specs.Responsibilities include managing folders, annotating medical records, data entry into QSHR, and ensuring 95% accuracy. Strong skills in PDF/Word/Excel, HIPAA compliance, and clear communication with project management are required.

Qualifications

• RN or LPN with unrestricted license.
• 2 years HEDIS abstraction/over-reading experience.
• Data entry proficiency.
• Working knowledge of PDF, Word and Excel.
• Excellent written and communication skills.
• Database management.

Responsibilities

• Abstract medical records.
• Apply product/plan specific abstraction criteria during medical record review.
• Maintain defined productivity volumes.
• Sustain 95% accuracy during abstraction and data entry.
• Perform quality reviews of abstracted medical records.
• Ensure HIPAA and confidentiality compliance.
• Attend scheduled project meetings and escalate issues as needed.
• Other duties as assigned.

Skills

HEDIS abstraction

Data entry

Communication skills

RN/LPN license

Database management

Education

RN or LPN license (unrestricted)

Tools

QSHR proficiency

Microsoft Word

Microsoft Excel

PDF tools

Job description

Spectraforce Technologies is seeking a RN or LPN for a remote HEDIS Review Nurse assignment of 4+ months. You will perform medical record abstractions and overreads for the annual NCQA HEDIS survey, following NCQA guidelines and technical specs.Responsibilities include managing folders, annotating medical records, data entry into QSHR, and ensuring 95% accuracy. Strong skills in PDF/Word/Excel, HIPAA compliance, and clear communication with project management are required.