Quality Technician - Steward Health Care Network
Position Purpose: Retrieve and audit medical records in order to accurately calculate HEDIS and other quality management performance measures, improve performance measure rates by outreach.
Meet goal of retrieving 95% of records per project (includes retrieving claims screen shots from claims system, medical records from electronic medical records systems, faxes and mail); track, trend and escalate barriers to supervisor.
Audits medical records with a 98% accuracy rate per HEDIS or other performance measures’ technical specifications; documents findings in electronic tools; meets project productivity goals.
Organizes and executes outreach activities (mailings, text messaging, newsletters, etc.), keeps projects on track at all times, serves as main point of contact for vendors, checks accuracy and completeness of vendor’s work, creates outreach lists from electronic tools and transmits them to vendors, documents activities in electronic tool.
Prepare and submit accurate productivity and project reports.
This position may be located out of any of the following Health Choice offices: Flagstaff AZ, Phoenix AZ, Salt Lake City UT, Dallas TX, Needham MA. For candidates within commuting distance of those offices, remote work (telework) may be available based on business needs and job performance, after successful completion of an in-office training period.
· LPN, RHIT, certified medical coder, CPHQ, CCS, CCS-P, RHIT, CDEO, CPMA, CPC, CRC, CHCA or similar credential, or comparable work experience
Years of Experience:
· 4 years of work experience
Work Related Experience:
· Two (2) or more years of experience in auditing medical records against specific technical specifications
· Computer skills, i.e., using various software, including intermediate Excel skills (sort, filter, reformat data, etc.)
· Successful experience implementing and overseeing completion of long-term assignments
· Self-directed, ability to thrive in a fast-paced, paper-free environment
· Comprehensive knowledge of computers and software such as Microsoft Windows, Windows Explorer, Outlook, Excel, Word, PDF file creation and conversion
· Ability to learn basic working skills with new software in short timeframes
· Strong oral, phone and written communication skills
· Strong knowledge of health information privacy and security rules and regulations
· Ability to effectively interact with people when meeting for the first time
· Ability to adapt to new surroundings and changing office environments
· Establish positive and professional relationships with care provider offices, clinics, hospitals, other clinical facilities and Health Choice staff.