Medical Record Review Nurse
PacificSource Health Plans - Bend, OR

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Overview:
Temporary contract position to review medical charts at Bend PacificSource office and find chart elements needed for annual HEDIS audit of care provided to Medicare members. May also audit charts for Physician Medical Record Review audits which assess record keeping against standards

  • This is a temporary part-time position that we anticipate will last approximately two months.
Responsibilities:
Medical Record Review and Data Abstraction (95%)
The medical record review on the members in the population will be performed according to NCQA HEDIS specifications.
Data will be entered using certified HEDIS software on laptop computer after training has been completed.
The medical record will be reviewed for confirmation of member identification, data elements, numerator events and contraindications per HEDIS specifications outlined on MRR tools in the certified software system.
Numerator events and contraindications will be documented in the software program and by photocopying, printing, or capturing a digital image of the page of the medical record where the event or contraindication is found.
Ability to audit with 95% accuracy.
Safeguard Protected Health Information (5%)
Always lock computer when leaving its location.
Do not reveal passwords.
Do not discuss PHI with anyone who does not have a legal need to know.
All photocopied medical records will be handled according the health plan confidentiality and safe guarding PHI policy and procedure.

Supporting Responsibilities:
Use of digital camera
Meet department and company performance and attendance expectations.
Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected
health information.
Perform other duties as assigned.

Qualifications:
Work Experience: Acute care experience or experience in a primary care clinic or experience with disease management. Experience performing chart audits preferred.

Education, Certificates, Licenses: Valid Oregon nursing license.

Knowledge: Knowledge of standards of care for diabetes.

Environment: Duties are performed primarily in PacificSource Bend office and possibly in medical clinics.

Physical Requirements: Ability to lift and carry and a laptop and case weighing approximately 15 lbs. Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions.
Repetitive motions to include typing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

PacificSource is an equal opportunity and affirmative action employer.

PacificSource Health Plans - 19 months ago - save job - block
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About this company
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PacificSource Health Plans is anything but a typical health plan. We’re a growing, independent, not-for-profit organization with a...