HEDIS Quality Assurance with AAPC/AHIMA-certified
Minnetonka Mills, MN- onsite
6-12+ Months C2H
JD:
We are seeking a knowledgeable and experienced AAPC/AHIMA-certified Professional Coder to support Quality Assurance (QA) 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.
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Key Responsibilities:
• Perform Quality Assurance (QA) 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
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Required Qualifications:
• AAPC or AHIMA certification (mandatory)
• Proven experience in HEDIS measures and reporting
• Hands-on experience in QA 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 (ICD-10, CPT, HCPCS)
• Strong analytical skills and attention to detail
• Excellent communication and documentation skills
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Preferred Qualifications:
• Experience working with health plans / payer environments
• Exposure to chart abstraction and medical record review • Familiarity with HEDIS tools, systems, or platforms • Experience in audit or compliance-related roles
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Key Skills:
• HEDIS QA & Validation
• Medical Coding (ICD-10, CPT)
• NCQA Guidelines Interpretation
• Chart Review & Audit
• Data Accuracy & Compliance
Best Regards,
Navneet Jha
D : 848-999-0314Â |Â Email:Â navneet.jha@siriinfoinc.com
Siri InfoSolutions Inc, 3 Ethel Rd, Suite # 302, Edison NJ 08817.
