Coding Quality Auditor, HEDIS – Remote
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 HEDIS program
Review outpatient medical records, hospital records, clinical lab, and pharmacy records as part of audits
Collect data based on standardized methodologies and organize it to identify opportunities for improvement
Perform chart audits electronically during the audit season
Complete HEDIS training prior to performing chart abstractions
Receive direction regarding charts requiring auditing
Maintain all collected records in a confidential manner
Perform all duties in a manner that promotes teamwork and reflects the Sisters of Providence mission and philosophy
Communicate collaboratively with clinic and other staff in a manner that represents Sisters of Providence
Required Qualifications
Technical certification/licensure in Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse upon hire
High School Diploma or GED
At least 3 years of medical record audit experience, including extraction of clinical data points from medical records and familiarity with electronic medical records
At least 2 years of HEDIS, quality management, quality improvement, or utilization review auditing experience, including experience in auditing within electronic health records
Experience in the medical field as a Medical Assistant, Certified Nurse Assistant, or Licensed Practical Nurse (LPN) for a minimum of 1 year
Preferred Qualifications
Associate’s Degree in Nursing, Healthcare, or Health Information Management
Experience with health plans, project management, data analysis, and/or case review
Remote Eligibility
Alaska
Washington
Montana
Oregon
California
Texas – Levelland, Lubbock or Plainview area
New Mexico
Alabama
Arizona
Delaware
Florida
Iowa
Idaho
Michigan
Minnesota
North Carolina
New Jersey
Utah
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, marital status, genetic information, or any other basis prohibited by local, state, or federal law.