We are seeking a knowledgeable and experienced AAPC/AHIMA-certified Professional Coder to support quality assurance activities for HEDIS measure charts. The ideal candidate will have strong expertise in HEDIS measures, chart review, and quality validation, along with the ability to independently interpret NCQA guidelines.
Key responsibilities include:
- Perform quality assurance on HEDIS measure charts and abstraction results
- Review and validate accuracy, completeness, and compliance of HEDIS data
- Analyze HEDIS measurement specifications and ensure adherence to NCQA guidelines
- Conduct detailed chart reviews to identify gaps, inconsistencies, and coding errors
- Interpret and apply HEDIS technical specifications during QA validation
- Perform independent research on HEDIS requirements using the NCQA manual
- Collaborate with internal teams to resolve discrepancies and improve data quality
- Provide feedback and recommendations to enhance QA processes and outcomes
Requirements & Qualifications
- AAPC or AHIMA certification required
- Proven experience in HEDIS measures and reporting
- Hands-on experience in quality assurance of HEDIS measure results
- Strong understanding of NCQA HEDIS guidelines and specifications
- Ability to independently research and interpret NCQA manual requirements
- Solid knowledge of medical coding standards including ICD-10, CPT, and HCPCS
- Strong analytical skills and attention to detail
- Excellent communication and documentation skills
Benefits & Perks
- Discretionary annual incentive
- Comprehensive medical coverage including medical, dental, vision, disability, and pet insurance
- Family support including maternal and parental leave
- Insurance options including auto and home insurance, and identity theft protection
- Commuter benefits and certification/training reimbursement
- Vacation, time off, sick leave, and holidays
- Legal assistance, 401(k) plan, performance bonus, college fund, and student loan refinancing
Location
Minnesota, US
Employment Type
Full-time
Experience Level
Senior
Salary Range
$100,000 - $120,000
Remote work allowed
No
Posted
4 weeks ago
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