Who we are:
Meridian is a family-owned, family-operated company of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry.
We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in three different states (Michigan, Illinois, and Ohio).
Our employees work hard, play hard, and give back. Meridian employees enjoy: Happy hours, special events, company sports teams, potlucks, Bagel Fridays, weekly Executive Lunches, and volunteer opportunities.
A Day in the Life of a Medical Record Data Abstractor:
This position is responsible for ongoing medical record data collection from contracted Provider offices and conducting medical record data entry. In an effort to support HEDIS (Healthcare Effectiveness Data Information Set) reporting and Quality Improvement initiatives, the abstractor is responsible for completing data mining initiatives and utilizes resources available to identify numerator compliant HEDIS information. Abstractors develop professional relationships with providers and health systems while pursuing opportunities in gaining Remote Access and EDI transmissions.Responsibilities
- Follows established procedures for chart chases, data mining, scheduling and conducting chart abstractions
- Coordinates and reports chart review schedule with Team Lead and Provider Network Development Representative in designated territory
- Timely notification to Team Lead, Manager and offices if appointments are cancelled or changed
- Extracts pertinent HEDIS data at designated hospitals, specialty facilities and provider offices using Meridian’s Managed Care System, current remote access databases and laboratory systems
- Improves quality of data retrieved by reviewing proper documentation protocols, billing standards and clinical practice guidelines with health systems and providers
- Works collaboratively with contracted Health Partners and Health Systems by facilitating, coordinating and implementing Electronic Data Exchanges
- Facilitates and maintains Remote Access Exchanges with Health Systems and Providers
- Ensures that all information is collected in a safe, organized and confidential manner
- Provides feedback to Team Lead regarding the abstraction process, resources required to complete abstractions and other concerns related to chart abstraction
- Communicates effectively and professionally with provider offices, Network Development Team’s and Leadership
- Meets and/or exceeds quarterly interrater reliability audits
- Collects, tracks and processes record data for Quality Monitoring and Improvement
- Maintains relationships with subject matter experts (SME’s), clinic managers, and provider office staff to facilitate medical record abstracting processes including scheduling time to enter data at health centers around clinic schedules
- Conducts Focused Provider Office Site Audits to monitor and report compliance with Meridian standards
- Utilize innovative, critical and strategic thinking to improve current data mining, abstraction and networking techniques
- Exudes Passion, Exemplifies Integrity, Promotes Quality and Possesses Vision
- Perform other duties as assigned
What you can bring to Meridian:
- High School Diploma is required
- Bachelor’s degree or Fellow designation from the Academy for Healthcare Management (AHM) is preferred
- Prior HEDIS clinical field experience and HEDIS certified software experience is preferred but not required
- Previous experience in managed health care and Medicaid programs is preferred
- Detailed knowledge of computers/systems including word processing and Excel spreadsheets
- Strong knowledge base of HEDIS Technical Standards
- Knowledge of claims and coding sets
- Knowledge of MS Project software
- Analytical and investigational background
- Strong knowledge base of HEDIS Technical Standards and HEDIS Compliance Audit Standards preferred
What Meridian can offer you:
- Our healthcare benefits include a variety of PPO plans that are effective on the first day of employment for our new full-time team members.
- Opportunity to work with the industry’s leading technologies and participate in unique projects, demonstrations, conferences, and exclusive learning opportunities.
- Meridian offers 401k matching that is above the national average.
- Full-time MHP employees are eligible for tuition reimbursement towards Bachelor’s or Master’s degrees.
- Meridian’s Chicago location is conveniently located in the Chicago Loop, and provides commuting benefits including discounts for public transportation and parking structures
- Regular activities such as sports leagues, “mix ‘n’ mingle” events, and volunteer opportunities take place in neighborhoods throughout the city
- Meridian is an Equal Opportunity Employer