Quality Improvement Abstractor

Summary:

• Work Mode: 100% Remote NC – Candidates must reside in NC
• Duration: 7 months, extension is possible
• Shift: Training 2-week course: M-F 8am-5pm EST – Working schedule M-F 8am-5pm EST

Responsibilities:

• Assist with retrieval of medical records.
• Work with the HEDIS Ops and Risk Adjustment teams to collect member records by contacting providers and placing collected records into the database utilized.
• Handle a high volume (40-50 per day) of inbound and outbound calls with provider offices.
• Follow up on requested medical records until obtained.
• Document research and contact information accurately.
• Label records with appropriate naming conventions.
• Load medical records to the abstraction database.

Requirements:

• Required: Associate Degree RN – NC or Compact state license.
• Required: LPN - NC.
• Minimum 4 years of nursing experience (active RN required).
• At least 1 year of experience in medical record review, quality improvement, or related administrative clinical work, call center.
• Disqualifiers: No active RN/LPN license or lapsed/expired license, lack of experience with medical record systems or electronic documentation, inability to commit to full-time schedule during the contract period, limited computer proficiency, refusal or inability to be on camera for required training and testing.

Preferred Skills:

• Bachelor degree preferred.
• Strong organizational skills and attention to detail.
• Ability to handle a high-volume workload under tight timelines.
• Professional communication and follow-up skills with provider offices.
• Reliability and accountability in meeting daily call/fax and documentation expectations.
• Top 3 must-have hard skills:
  • Medical record retrieval and documentation accuracy (critical for data integrity).
  • Strong computer skills (Excel, medical record software, and ability to pass computer testing).
  • Effective provider communication (handling high call/fax volume with professionalism).