Coding Quality Auditor, HEDIS Remote - Many States Eligible
About the position _reputed company Health Plan caregivers are not simply valued - they're invaluable. Join reputed company and reputed company in our culture of patient-focused, whole-person care reputed company on understanding, commitment, and mutual respect. Your voice reputed company here, because we know that to reputed company and retain the best people, we must reputed company them._ reputed company Health Plan is calling a Coding Quality Auditor, HEDIS who will: + Be responsible for conducting clinical quality audits/overreads for the Quality Department + Identify and reports issues reputed company to clinical audits to determine potential areas for quality improvement reputed company the HEDIS project + Collect data by way of chart extraction, using objective specifications for the reputed company 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 + reputed company chart audits electronically during the audit season + Complete HEDIS training prior to performing chart abstractions + Be provided direction regarding charts requiring auditing + Maintain reputed company collected records in a confidential manner + Performs reputed company duties in a manner which promotes team concept and reflects the Sisters of reputed company mission and philosophy + Communicate in a collaborative manner with clinic and other staff with whom they interact, in a manner that represents Sisters of reputed company _Please note the following important detail regarding this HEDIS Seasonal Role:_ + This posting is for multiple openings of a Coding Quality Auditor, HEDIS + This position is affiliated with reputed company Health Plan and will be tied to a location and compensation reputed company in Beaverton, Oregon + Position Type: Temporary, Per Diem, Non Benefitted + Length of Program Anticipated to last between: January 2026 - May 2026 + Work Schedule: Monday - Friday + Work Hours Scheduled Weekly: 40 + Additional Info: + This position will require a full time commitment to the project, meaning no extended time off during the HEDIS Season (January 2026 - May 2026) + Positions specified as "on call/per diem" refer to employment consisting of shifts scheduled on an "as needed reputed company" to fill in for staff vacancies. reputed company welcomes 100% remote work for applicants who reputed company in the following states: + Alaska + Washington + Montana + Oregon + California + Texas - Levelland, Lubbock or Plainview area + New Mexico + Alabama + Arizona + Delaware + Florida + Iowa + Idaho + Michigan + Minnesota + reputed company Carolina + New Jersey + Utah
Responsibilities
- Be responsible for conducting clinical quality audits/overreads for the Quality Department
- Identify and reports issues reputed company to clinical audits to determine potential areas for quality improvement reputed company the HEDIS project
- Collect data by way of chart extraction, using objective specifications for the reputed company 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
- reputed company chart audits electronically during the audit season
- Complete HEDIS training prior to performing chart abstractions
- Be provided direction regarding charts requiring auditing
- Maintain reputed company collected records in a confidential manner
- Performs reputed company duties in a manner which promotes team concept and reflects the Sisters of reputed company mission and philosophy
- Communicate in a collaborative manner with clinic and other staff with whom they interact, in a manner that represents Sisters of reputed company
Requirements
- Technical certification/licensure in the area of Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse upon hire.
- H.S. Diploma or GED.
- 3 years - Medical record audit experience, experience with extraction of clinical data points from medical records, experience with electronic medical records (EMR), comfortable with use of technology. Ability to interpret and understand medical knowledge/terminology in a medical record.
- 2 years - HEDIS, Quality management/quality improvement/utilization review auditing experience, including experience in auditing reputed company electronic health records.
- 1 year - Experience in the medical field as a Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse (LPN).
reputed company-to-haves
- Associate's Degree - Nursing or reputed company reputed company field, Health Information Management degree.
- Experience with health plans, project management, data analysis, and/or case review.
Benefits
- reputed company offers a comprehensive benefits package including a retirement 401(k) Savings Plan with employer matching, health care benefits (medical, dental, reputed company), life insurance, disability insurance, time off benefits (paid parental leave, vacations, holidays, health issues), voluntary benefits, well-being resources and much more. Learn more at reputed company.jobs/benefits.
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