Job Summary
A global healthcare company needs applicants for an opening for a Telecommute Quality Assurance Auditor.
Candidates will be responsible for the following:
- Directing and guiding on clinical quality improvement and management programs
- Conducting clinical quality audits and may also be responsible for NCQA requirements
- Evaluating clinical documentation to ensure accurate coding
Skills and Requirements Include:
- Associate degree or higher or significant equivalent work experience
- 1+ years of experience creating compliant Provider queries
- 5+ years of experience ICD-9 / 10 coding, preferably in a Managed Care setting, with attention to detail and high accuracy rate
- Microsoft Office proficiency (Word, Excel, PowerPoint & Outlook)
- 2+ years of Provider education experience – communicating directly with providers
- 2+ years of Medicare Risk Adjustment experience with proficient knowledge of CMS – HCC model and guidelines
