Coding Quality Auditor

Providence Health & Services
life insurance, parental leave, 401(k), remote work
United States, Texas, Houston
Dec 24, 2024
Description Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them. Providence 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 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 *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 Providence Health Plan and will be tied to a location and compensation range in Beaverton, Oregon Position Type: Temporary, Per Diem, Non Benefitted Length of Program Anticipated to last between: January 2025 - May 2025 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 2025 - May 2025) Positions specified as "on call/per diem" refer to employment consisting of shifts scheduled on an "as needed basis" to fill in for staff vacancies. Providence welcomes 100% remote work for applicants who reside in the United States. Note: Providence is not currently considering applicants who reside in the following States: Colorado Hawaii Massachusetts New York Ohio Pennsylvania Required qualifications for this position include: 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 qualifications for this position include: Associates Degree in Nursing or Healthcare field, Health Information Management Experience working with health plans, project management data analysis and or case review Why Join Providence Health Plan? Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities. About Providence At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable. The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities. Providence offers a comprehensive benefits package including a retirement 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 and much more. Learn more at providence.jobs/benefits. About the Team Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise. Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement. Requsition ID: 329475 Company: Providence Jobs Job Category: Coding Job Function: Revenue Cycle Job Schedule: Per-Diem Job Shift: Day Career Track: Business Professional Department: 5018 HCS QUALITY MANAGEMENT OR REGION Address: OR Beaverton 3601 SW Murray Blvd Work Location: Murray Business Ctr Beaverton-Beaverton Workplace Type: Remote Pay Range: $34.96 - $55.34 The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.