HEDIS Clinical Terminologist

Job Summary

A company is looking for a HEDIS Clinical Terminologist (Contract).

Key Responsibilities

• Review EHR and PDFs of medical records to collect and validate HEDIS conformant data elements
• Abstract and code clinical data from medical records in compliance with HEDIS and STARS standards
• Participate in audits, quality assurance, and product improvement activities as needed

Required Qualifications

• 2+ years of recent HEDIS abstraction experience, including familiarity with STARS measures
• Strong clinical acumen with the ability to translate clinical information into codified concepts (e.g., ICD10, HCPCS, CPT, SNOMED, LOINC)
• Strong knowledge of NCQA HEDIS guidelines and CMS STARS specifications
• Experience using HEDIS abstraction tools
• Relevant certifications such as LPN, RN, or Medical Assistant