Providence Health & Services
Coding Quality Auditor, HEDIS *Remote*
Providence Health & Services, Oregon, Wisconsin, United States, 53575
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Coding Quality Auditor, HEDIS *Remote*
role at
Providence Health & Services
2 days ago Be among the first 25 applicants
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.
Responsibilities
Conduct clinical quality audits/overreads for the Quality Department
Identify and report issues related to clinical audits to determine potential areas for quality improvement within the HEDIS project
Collect data by 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 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 confidentially
Perform all duties in a manner that promotes team concept and reflects the Sisters of Providence mission and philosophy
Communicate collaboratively with clinic and other staff represented by Sisters of Providence
Qualifications
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 of medical record audit experience, experience extracting clinical data points from medical records, experience with electronic medical records (EMR), comfortable with technology, ability to interpret medical knowledge/terminology in a medical record
2 years of HEDIS, quality management/quality improvement/utilization review auditing experience, including experience auditing within electronic health records
1 year of experience in the medical field as a Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse (LPN)
Preferred Qualifications
Associate's Degree in Nursing or Healthcare related field, Health Information Management degree
Experience with health plans, project management, data analysis, and/or case review
Benefits Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security…
Why Join Providence? 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.
Remote Work Providence welcomes 100% remote work for applicants who reside in the following states: Alaska, Washington, Montana, Oregon, California, Texas - Levelland, Lubbock or Plainview area, New Mexico.
Location Associated with Providence Health Plan; tied to a location and compensation range in Beaverton, Oregon. Work schedule: Monday-Friday, 40 hours weekly.
Seniority Level Mid-Senior level
Employment Type Full-time
Job Function Quality Assurance
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Coding Quality Auditor, HEDIS *Remote*
role at
Providence Health & Services
2 days ago Be among the first 25 applicants
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.
Responsibilities
Conduct clinical quality audits/overreads for the Quality Department
Identify and report issues related to clinical audits to determine potential areas for quality improvement within the HEDIS project
Collect data by 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 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 confidentially
Perform all duties in a manner that promotes team concept and reflects the Sisters of Providence mission and philosophy
Communicate collaboratively with clinic and other staff represented by Sisters of Providence
Qualifications
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 of medical record audit experience, experience extracting clinical data points from medical records, experience with electronic medical records (EMR), comfortable with technology, ability to interpret medical knowledge/terminology in a medical record
2 years of HEDIS, quality management/quality improvement/utilization review auditing experience, including experience auditing within electronic health records
1 year of experience in the medical field as a Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse (LPN)
Preferred Qualifications
Associate's Degree in Nursing or Healthcare related field, Health Information Management degree
Experience with health plans, project management, data analysis, and/or case review
Benefits Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security…
Why Join Providence? 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.
Remote Work Providence welcomes 100% remote work for applicants who reside in the following states: Alaska, Washington, Montana, Oregon, California, Texas - Levelland, Lubbock or Plainview area, New Mexico.
Location Associated with Providence Health Plan; tied to a location and compensation range in Beaverton, Oregon. Work schedule: Monday-Friday, 40 hours weekly.
Seniority Level Mid-Senior level
Employment Type Full-time
Job Function Quality Assurance
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