Clinical Abstractor @ Optum

Job Description

Optum is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come make an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start  Caring. Connecting. Growing together.

  The IOA assists providers in targeting those patients that have gaps in HEDIS measures and/or have not been seen in the office within the last year. IOA also helps providers improve the accuracy of risk adjustment documentation and abstraction and maximize the health plan indicator scores in the Centers for Medicare & Medicaid Services (CMS) Five Star Quality Rating System. The provider can bring the patient in for a comprehensive exam while also offering treatment in alignment with the NCQA measurements. This information is then reported back to Optum for coding for risk adjustment and HEDIS reporting.

 Primary Responsibilities

 

Abstracts patient charts and pull the information from the chart so it can be submitted to the NCQA during the PSV audit. This function is accomplished in a prompt and reasonable timeframe in accordance with productivity and accuracy standards

Synopsize important information from patient records for accuracy

Reviewing medical records and abstracting necessary information to close the gap on the quality measure

Keep abreast of the guidelines and updates

Update skill and knowledge levels in accordance with NCQA

Complies with confidentiality standards and HIPAA privacy regulations

Perform other tasks and projects as needed by chart operations

Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so #NTRQ

 Required Qualifications

 

Graduation from Lifescience Background / Medical allied

Proficient computer skills

Proven attention to detail

Proven good communication skills (both verbal and written)

Job Classification

Industry: Retail
Functional Area / Department: Healthcare & Life Sciences
Role Category: Healthcare & Life Sciences - Other
Role: Healthcare & Life Sciences - Other
Employement Type: Full time

Contact Details:

Company: Optum
Location(s): Chennai

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