
Highly organized and detail-oriented HEDIS Abstractor and Medical Retrieval
Operation Analyst with over 5 years of experience in healthcare quality data
abstraction, medical record retrieval, and compliance with HEDIS measures.
Proficient in analyzing clinical documentation, managing data accuracy, and
collaborating with cross-functional teams to improve healthcare performance
metrics. Demonstrates exceptional knowledge of medical terminology, coding
systems (ICD, CPT, HCPCS), and HIPAA compliance. Adept at using healthcare
information systems, EHR platforms, and data analytics tools to drive operational
efficiency.
• Achieved an impressive accuracy in medical record review and abstraction.
• Transcribing Orders, communicating Critical results, Order corrections and
support with general Lab workflows including AP/CP.
• Review and abstract medical records to meet HEDIS measure requirements,
ensuring accurate and timely data submission.
• Validate and reconcile data discrepancies in clinical documentation with
providers and healthcare teams
• Utilize EHR systems to identify gaps in care and collaborate with clinical teams
to implement quality improvement measures.
• Ensure compliance with NCQA standards and guidelines during the data
abstraction process.
• Prepare comprehensive reports on HEDIS performance metrics to inform
organizational decision-making.
• Supported audit readiness by delivering precise documentation and resolv
• Improved HEDIS compliance rate through precise abstraction and proactive
issue resolution.
• Mentored new abstractors on HEDIS measure requirements and EHR usage.
• Assisted in abstracting medical data for quality improvement projects.
• Reviewed and verified documentation supporting diagnosis, procedures, and
treatment results.
• Worked on an EMR team, completing medical records via remote access to
provider EMR/HER systems.
• Analyzed, abstracted, and compiled medical information from patient records as
a service to physicians, researchers, and offices associated with patient care.
• Entered new patient information, extracted relevant information from medical
records, and updated patients’ data.
• Reviewed and abstracted medical records to support HEDIS quality measures,
ensuring regulatory compliance.
• Ensured proper coding of medical procedures, diagnoses, and treatments.
• Corrected rejected claims and maintained strict HIPAA regulations to protect
client privacy.
• Provided actionable insights to improve data accuracy and support healthcare
decision-making.
• Prepared comprehensive reports on HEDIS performance metrics to inform
• Managed end-to-end medical record retrieval processes for HEDIS and other quality reporting programs.
• Coordinated with healthcare providers to obtain necessary documentation while maintaining HIPAA compliance.
• Maintained comprehensive knowledge of HEDIS measures, ensuring data integrity and compliance.
• Analyzed retrieval data to identify bottlenecks and implemented process improvements to increase retrieval rates.
• Maintained accurate and organized records of retrieved charts and ensured adherence to deadlines.
• Provided detailed progress reports to stakeholders, including status updates andrisk assessments.
• Conducted comprehensive medical record reviews, achieving 97% accuracy across 60+ charts daily.
• Collaborated with cross-functional teams to optimize data collection and reporting processes.
• Ensured adherence to federal and state compliance standards, maintaining HIPAA confidentiality throughout.