EPITEC
Overview
Position:
Quality Audit Specialist (SPARK) Location:
Chicago, IL (Hybrid) Employment Type:
Full-Time Contract Pay:
$41-$45 per hour 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 of maintenance of accreditation with national accreditation agencies. Responsibilities
Conduct clinical validation on incoming supplemental data files Maintain standard operating procedures (SOPs), user guides to reflect accurate and updated processes Educate internal and external stakeholders (e.g., providers, vendors) in supplemental processes Support clinical validation during the onboarding process including primary source verification (PSV) during official/mock audits Conduct analysis and investigation on inquiries related to medical records data collection tied to technical specifications Collaborate with technical staff in performing research and assist in data analysis Maintain productivity level with less than a 5% error rate in record abstraction and data entry on an ongoing basis 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 Qualifications
High School Diploma Understanding of NCQA HEDIS quality measures and code value sets Strong proficiency with 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 Benefits
Medical, Dental, and Vision Insurance. Paid time off. 401K.
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Position:
Quality Audit Specialist (SPARK) Location:
Chicago, IL (Hybrid) Employment Type:
Full-Time Contract Pay:
$41-$45 per hour 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 of maintenance of accreditation with national accreditation agencies. Responsibilities
Conduct clinical validation on incoming supplemental data files Maintain standard operating procedures (SOPs), user guides to reflect accurate and updated processes Educate internal and external stakeholders (e.g., providers, vendors) in supplemental processes Support clinical validation during the onboarding process including primary source verification (PSV) during official/mock audits Conduct analysis and investigation on inquiries related to medical records data collection tied to technical specifications Collaborate with technical staff in performing research and assist in data analysis Maintain productivity level with less than a 5% error rate in record abstraction and data entry on an ongoing basis 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 Qualifications
High School Diploma Understanding of NCQA HEDIS quality measures and code value sets Strong proficiency with 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 Benefits
Medical, Dental, and Vision Insurance. Paid time off. 401K.
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