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HEDIS Audit Analyst

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Dayton, OH

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Job Description
Onebrdige is actively seeking a HEDIS Audit Analyst for a full time opportunity located in Dayton, OH.\rJob Title: HEDIS Audit Analyst  \rVertical: Healthcare\rLocation: Dayton, OH\rHEDIS Audit Analyst Overview:\rHandling a high volume of telephonic interaction with provider offices \rFollowing up on requested medical records with providers \rKeeping excellent documentation of research and contact information \rAssess vendor-delegated abstraction activities and compare results to HEDIS standards and/or custom or other measure set standards \rReview medical records and abstract data for HEDIS and other measure sets in compliance with standards \rTrack and report on issues and outcomes related to abstractions and over-reads \rCommunicate outcomes of abstraction and over-sight activities with health plans and vendors when required \r1st shift, 40 hours/week\r\r \rTop Required Skillsets:\rRelevant clinical experience involving medical claims experience and medial record audit experience.\rPrevious experience with navigating CPT4 codes and ICD9 and ICD10 DX based on HEDIS technical specification. \rIntermediate proficiency in Microsoft Word, Excel.\r \r

Job Requirements
HEDIS Audit Analyst Job Requirements:\rHard Requirements:\r\r \r At least two years of relevant clinical experience involving medical claims experience and medial record audit experience\r \r\r\r Previous experience with navigating CPT4 codes and ICD9 and ICD10 DX based on HEDIS technical Specification\r Multi-Tasking ability\r Intermediate proficiency in Microsoft Word, Excel\r Excellent written and oral communications skills\r Ability to work independently and within a team environment\r Decision making/problem solving skills\r Situational awareness\r Knowledge of Medicaid/Medicare preferred\r Excellent customer service skills\r Critical listening and thinking skills\r Ability to manage and meet workloads and deadlines\r\r \rPreferred Requirements:\r\r Managed Care experience\r Experience in quality initiatives (including HEDIS project, study analysis, or NCQA standards)\r Proficiency in Microsoft SharePoint\r Licensed Practical Nurse (LPN) and/or Registered Nurse (RN) license (in any state) , or Associates, or Bachelor’s Degree\r\r \rOnebridge offers competitive compensation and access to a comprehensive program which includes: Medical, Dental, Vision, Flexible PTO, Holiday Pay, and 401K.

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