Job Description

Here are the job details for your review:

Job Title: HEDIS Reviewer II

Duration: 5 Months Contract (Potential for extension)
Location: Remote

Shift Hours: Monday thru Friday, 8 hours worked, between the hours of 8am and 5pm local time

Start date - 01/05/2026

Note:

• Participates in the collection and review of medical records to abstract clinical information for HEDIS quality reporting.
• Training will be provided prior to the start of the assignment.
• May be selected to do an onsite visit to a provider's office to collect medical records, only as needed.

Questionnaire:

• Is the name listed on your resumes your legal name and spelt correctly, if not please provide that name?
• What is your current address (including the Apartment unit # and info if applicable)? Suppliers make sure this matches in Fieldglass
• Do you have an alternate phone number to what is already on your resume?
• Are you able to work Monday thru Friday, 8 am to 5 pm your local time (January thru May) without interruption?
• Do you have anything that requires time off or would prevent you from working the above required schedule (January thru May)?
• Please list 3 different Microsoft Office Suite Programs you have experience with and how many years you've worked in each one.
• Are you able to connect the Aetna provided laptop to your home internet modem via an ethernet cable connection? (Not thru a WiFi connections)
• Do you have the reliable transportation to travel to a provider's office, if needed?

• Are you able to carry equipment that weigh up to 20lbs?

Description:

• This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS and CMS performance measures.
• Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements.
• The candidate must be proficient with databases and with conducting 100% of work activities on the computer.
• Must commit to duration of the project with the understanding that work hours can be varied.
• Due to proprietary information, must inform employer if they are planning to accept employment with another company.

Duties:

• Complete assigned abstraction and data entry each day.
• Work with provider offices as needed to schedule/confirm appointments, follow up on medical record submission, and provide patient rosters
• Locate and review ALL assigned medical charts, perform abstraction, copy all supporting documentation per specifications and data enter into the applicable software system ALL assigned abstracts.
• Prioritize and accurately complete tasks within established times
• Identifying trends and documentation of areas for improvement
• Maintaining project productivity levels while maintaining accuracy requirements for abstraction and data entry activities

Experience:

• 
  Participates in the collection and review of medical records to abstract clinical information for HEDIS quality reporting. Training will be provided prior to the start of the assignment.
  
  
  This position interprets relevant clinical criteria through review of medical records, annotates via Adobe PDF and populates a data collection tool to support compliance with HEDIS and CMS performance measures. Ensures accurate and complete documentation of required information to meet risk management, regulatory, and accreditation requirements. The candidate must be proficient with databases and with conducting 100% of work activities on the computer.
  
  
  Must commit to duration of the project with the understanding that work hours can be varied. Due to proprietary information, must inform employer if they are planning to accept employment with another company.

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