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Job Requirements of Quality Audit Specialist (SPARK):
-
Employment Type:
Contractor
-
Location:
Chicago, IL (Onsite)
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Quality Audit Specialist (SPARK)
Careers Integrated Resources Inc
Chicago, IL (Onsite)
Contractor
Job Title: Quality Audit Specialist (SPARK)
Location: Chicago, IL 60601
Duration: 03 Months+ (Potential for Extension)
Shift timings: Standard hours - 8:00 AM to 5:00 PM (Mon-Fri)
Pay Rate: $42/hr to $45/hr on W2
This is Onsite/Hybrid in Chicago
Job Description:
Individual must demonstrate strong multi-tasking setting priorities based upon minimal direction including:
Location: Chicago, IL 60601
Duration: 03 Months+ (Potential for Extension)
Shift timings: Standard hours - 8:00 AM to 5:00 PM (Mon-Fri)
Pay Rate: $42/hr to $45/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.
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.
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