Job Description
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.
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
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
Salary Range: $100,000- $120,000 a year
Employee Benefits
Discretionary Annual Incentive
Comprehensive Medical Coverage: Medical & Health, Dental & Vision, Disability Planning & Insurance, Pet Insurance Plans
Family Support: Maternal & Parental Leaves
Insurance Options: Auto & Home Insurance, Identity Theft Protection
Convenience & Professional Growth: Commuter Benefits & Certification & Training Reimbursement
Time Off: Vacation, Time Off, Sick Leave & Holidays
Legal & Financial Assistance: Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing
Education
BACHELOR OF COMPUTER SCIENCE
#J-18808-Ljbffr