Providence Health & Services ยท 18 hours ago
Coding Quality Auditor
New Mexico, United States
Full-time
Remote
Mid Level
$34.96/hr - $55.34/hr
3+ years exp
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Responsibilities
Be responsible for conducting clinical quality audits/overreads for the Quality Department
Identify and reports issues related to clinical audits to determine potential areas for quality improvement within the HEDIS project
Collect data by way of chart extraction, using objective specifications for the Healthcare Effectiveness and Data Information Set (HEDIS) program
Conduct Audits inclusive of review of outpatient medical records, hospital records, clinical lab and pharmacy records
Be responsible for collecting data based on standardized methodologies
Organize the data to identify and address opportunities for improvement
Perform chart audits electronically during the audit season
Complete HEDIS training prior to performing chart abstractions
Be provided direction regarding charts requiring auditing
Maintain all collected records in a confidential manner
Performs all duties in a manner which promotes team concept and reflects the Sisters of Providence mission and philosophy
Communicate in a collaborative manner with clinic and other staff with whom they interact, in a manner that represents Sisters of Providence
Qualification
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Required
HS Diploma or GED Equivalency
Licensure / Certification: Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse
1+ years' experience in the medical field as a Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse (LPN)
3+ years of medical auditing experience
3+ years' experience with extracting clinical data points from medical records
3+ years' experience with electronic medical records (EMR)
3+ years' experience using technology in day to day work flow
3+ years' experience interpreting and understanding medical knowledge/terminology in a medical record
2+ years of HEDIS experience
2+ years' experience working with quality management / quality improvement in a nursing work environment
2+ years' experience with utilization review audits
2+ years' experience auditing within electronic health records
Preferred
Associates Degree in Nursing or Healthcare field, Health Information Management
Experience working with health plans, project management data analysis and or case review
Benefits
401(k) Savings Plan with employer matching
Health care benefits (medical, dental, vision)
Life insurance
Disability insurance
Time off benefits (paid parental leave, vacations, holidays, health issues)
Voluntary benefits
Well-being resources
Company
Providence Health & Services
At Providence, our strength begins with understanding.
10001+ employees
H1B Sponsorship
Providence Health & Services has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (23)
2022 (33)
2021 (32)
2020 (24)
Funding
Current Stage
Late StageLeadership Team
Jennifer Burrows
Chief Executive Officer
Rod Hochman
President and CEO
Recent News
2024-11-29
oregonlive.com
2024-10-26
Providence Business News
2024-10-26
Company data provided by crunchbase
