Coding Quality Auditor @ Providence Health & Services | Jobright.ai
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Coding Quality Auditor jobs in Oregon, United States
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Providence Health & Services ยท 13 hours ago

Coding Quality Auditor

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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

Find out how your skills align with this job's requirements. If anything seems off, you can easily click on the tags to select or unselect skills to reflect your actual expertise.

Medical AuditingClinical Data ExtractionElectronic Medical Records (EMR)HEDIS ExperienceQuality ManagementUtilization Review AuditsAuditing Electronic Health RecordsMedical TerminologyMedical Assistant CertificationCertified Nurse AssistantLicensed Practical Nurse (LPN)Data AnalysisProject Management

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

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At Providence, our strength begins with understanding.

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 Stage

Leadership Team

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Jennifer Burrows
Chief Executive Officer
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Rod Hochman
President and CEO
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Company data provided by crunchbase
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