Company:

AHIPL Agilon Health India Private Limited

Job Posting Location:

India_Bangalore

Job Title: ​

HEDIS Abstractor and Overreader

Job Description: ​

Essential Job Functions:

- Review and abstract clinical data from electronic medical records in alignment with HEDIS technical specifications
- Perform overreads of abstracted medical records for accuracy, completeness and measure compliance
- Demonstrate high level of proficiency in HEDIS measures and coding standards (including but not limited to ICD-10, CPT and CPTII) to close gaps in care
- Collaborate with internal and external partners to resolve documentation discrepancies and provide recommendations for improvement
- Support audit preparation and participate in internal quality reviews and training sessions
- Manages all activities to meet health plan contractual and reporting timeframes
- Identify trends in abstraction that may impact measure performance or audit readiness and proactively escalate to leadership

Other Job Functions:

- Other duties as assigned.

Required Qualifications:

Minimum Experience

- Minimum of 2 years’ experience working with NCQA HEDIS programs and/or HEDIS abstraction in all measures
- Proficiency in EMR platforms (i.e., Epic, Cerner) and abstraction tools
- Familiarity with Medicare Advantage lines of business and Stars Measures




- Familiarity with supplemental data processes and quality data integration

Education & Licensure

- Minimum of Bachelor’s degree or equivalent degree

Skills and Abilities:

- Ability to be a team player and exercise initiative in responding to team members or Sr. Manager.
- Thorough understanding of medical record documentation and medical terminology
- High level of attention to detail and ability to follow direction on project deadlines
- Ability to work independently
- Strong language skills in English speaking and understanding
- Ability to meet high productivity requirements and Interrater Reliability standards
- Strong Excel skills
- Ability to interpret compliance vs non-compliance on health plan gap file use to direct abstraction efforts.
- Ability to apply deep level of measure understanding to legal medical records
- Robust Adobe skills (including saving records in PDF format and annotation)
- Ability to interpret large data files for needed abstraction
- Deep level of ability to recognize medical records that are not complete or are missing needed data points in overreading
- Ability to report clearly on both positive or negative findings and apply possible solutions on Team calls

Location: ​

India_Bangalore

📌 HEDIS Abstractor and Overreader (Bengaluru)
🏢 Recognized
📍 Bengaluru