Quality Audit Specialist (SPARK)

Quality Audit Specialist (SPARK) Integrated Resources - Hosted Jobs - 3.3 Chicago, IL Job Details Contract $42 an hour 1 day ago Benefits Health insurance Dental insurance 401(k) Qualifications Research Clinical performance metrics SharePoint Health information management Productivity software

Full Job Description Job Title:

Quality Audit Specialist (SPARK)

Location:

Hybrid in Chicago, IL 60601

Duration:

06 Months (Potential for Extension) Shift timings: Standard hours - 8:00 AM to 5:00 PM (Mon-Fri)

Pay Rate:

$42/hr on W2 This is Onsite/Hybrid in

Chicago Job Description:

This position is responsible for ensuring the audit and review of electronic clinical records to ensure they accurately reflect medical record documentation to meet regulatory and accrediting compliance mandates. This position will be responsible for oversight and review of the abstraction/extraction process of clinical data from Electronic Medical Records (EMRs); auditing supplemental files supplied by providers and vendors for HEDIS, Quality Rating System (QRS) and other quality measures; identifying areas of opportunity to improve documentation and audit outcomes. This position impacts the integrity of the Medical Record validation process and HealthCare Effective Data & Information Set (HEDIS) Reporting. In addition, this position significantly contributes toward the achievement to maintenance of accreditation with national accreditation agencies.

Experience:

Experience with Coding or Certified Coding Certification with HEDIS experience Minimum of 3 year's Healthcare industry experience; healthcare data Strong experience with NCQA and HEDIS reporting, technical data analysis in formal audit formal audit environment. Individual must demonstrate strong multi-tasking setting priorities based upon minimal direction including: Understanding of

NCQA HEDIS

quality measures and code value sets. Conducts clinical validation on incoming supplemental data files. Maintains standard operating procedures (SOPs), user guides to reflect accurate and updated processes Educates internal and external stakeholders (e.g., providers, vendors) in supplemental processes Supports clinical validation during the onboarding process including primary source verification (PSV) during official/mock audits. Conducts analysis and investigation on inquiries related to medical records data collection tied to technical specifications Collaborates with technical staff in performing research and assist in data analysis Maintains productivity level with less than a 5% error rate in record abstraction and data entry on an ongoing basis. Strong proficiency with tools, language

MS Office Suite:

MS Word, MS Excel, MS PowerPoint, and MS SharePoint. Familiar with HIX (Health Insurance Exchange), EMR (Electronic Medical Record), EHR (Electronic Health Record) types of data collection. Apply structured auditing criteria to abstract medical records, follow defined procedures for saving approved medical record documentation and accurately enter the results of chart audits Maintain complete confidentiality of company related business. Maintain effective communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested. #

IRI-RN Pay:

$42.00 per hour

Benefits:

401(k) Dental insurance Health insurance

Work Location:

Hybrid remote in Chicago, IL 60601