[Remote] HEDIS Data Reviewer
Note: The job is a remote job and is open to candidates in USA. Elevait Solutions is seeking a HEDIS Data Reviewer to support their quality reporting initiatives. The role involves performing medical record abstraction and ensuring compliance with performance measures while maintaining high productivity standards.
Responsibilities
• Perform medical record abstraction and overread for HEDIS and State EQRO quality reporting.
• Coordinate medical record identification, collection, and review processes.
• Apply structured abstraction criteria to determine compliance with performance measures.
• Accurately enter audit results into designated databases or software systems.
• Maintain an abstraction proficiency rate of at least 98%.
• Provide feedback on non-compliant records and support providers as directed.
• Assist with medical record collection via phone, fax, or written requests.
• Complete assigned special projects and meet established productivity standards.
Skills
• HEDIS data abstraction and chart review
• Medical terminology and record interpretation
• Proficiency with medical record abstraction tools and Microsoft Office
• 3–5 years’ experience with HEDIS, QRS, or STARs data review and collection
• Strong understanding of current HEDIS Technical Specifications and audit processes (PSV, CSV, MRRV)
• Ability to accurately read and abstract medical records (notes, labs, screenings, immunizations, etc.)
• Excellent analytical, organizational, and communication skills
• Proficient in Excel, Word, PowerPoint, and Outlook
• Ability to work independently and meet productivity and accuracy goals
• Education: Associate’s Degree, RN, LPN, or equivalent relevant experience
• Experience: Minimum 3–5 years working with HEDIS data and medical record review
• Technical: Proficiency in Microsoft Office and medical record abstraction tools
• Other: Ability to work independently under deadlines with strong attention to detail
• Experience in Pediatric, Maternity, Diabetic, or Provider Office settings
• Familiarity with Cancer Registry and Bright Futures
• Prior experience supporting quality or compliance projects
Company Overview
• Elevait Solutions offers consulting and workforce solutions using proprietary machine-learning technology. It was founded in 2022, and is headquartered in Charlotte, North Carolina, USA, with a workforce of 201-500 employees. Its website is https://elevait.tech.
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