Medical Records Quality Assurance Specialist (Hiring Immediately)
You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, youll have access to competitive benefits including a fresh perspective on workplace flexibility.
Position Purpose: Responsible for developing and conducting training and quality auditing programs for the Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care.
ā¢ **The Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. ***
Responsibilities:
ā¢ Conducts auditing of work performed by staff and present findings and recommendation for areas of improvement to management
ā¢ Under minimal supervision responsible for all aspects of auditing projects that are broad in nature and require originality and/or ingenuity
ā¢ Assists with revisions to Policy and Procedure and/or work process development
ā¢ Conducts training needed analysis to determine specific training needs for clinical and coding staff
ā¢ Identifies, selects, or develops appropriate training programs, including the selection or design of appropriate training aids
ā¢ Maintains records of auditing and training activities and employee progress
ā¢ Performs other duties as assigned
ā¢ Complies with all policies and standards
Highly Preferred Skills:
ā¢ Inpatient Coding Experience
ā¢ At least 1 year of clinical experience in a hospital setting
ā¢ RN, PA, MD, APRN, DO or MBBS license required
ā¢ Strong written communication skills
Education/Experience: Associates degree in Nursing or equivalent experience. 4+ years of DRG and/or Medical Record Audit experience. One year of experience in a clinical setting or acute care hospital. Training or auditing experience in a managed care or healthcare setting.
Required License/Certification: RN, PA, MD, APRN, DO or MBBS license required
Preferred License/Certification: Valid/Current CPC or CIC Certification, through APPC desired or CCS through AHIMA; RHIA/RHIT Credentials desired.
Pay Range: $55,100.00 - $99,000.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Apply Now
Apply Now
Position Purpose: Responsible for developing and conducting training and quality auditing programs for the Diagnosis Related Group (DRG) and Medical Record Audit Programs for Fidelis Care.
ā¢ **The Clinical Coding Auditor & Trainer position is primarily remote with a small travel expectation on an annual basis. Candidates must be willing to travel to New York twice a year to be considered for the position. ***
Responsibilities:
ā¢ Conducts auditing of work performed by staff and present findings and recommendation for areas of improvement to management
ā¢ Under minimal supervision responsible for all aspects of auditing projects that are broad in nature and require originality and/or ingenuity
ā¢ Assists with revisions to Policy and Procedure and/or work process development
ā¢ Conducts training needed analysis to determine specific training needs for clinical and coding staff
ā¢ Identifies, selects, or develops appropriate training programs, including the selection or design of appropriate training aids
ā¢ Maintains records of auditing and training activities and employee progress
ā¢ Performs other duties as assigned
ā¢ Complies with all policies and standards
Highly Preferred Skills:
ā¢ Inpatient Coding Experience
ā¢ At least 1 year of clinical experience in a hospital setting
ā¢ RN, PA, MD, APRN, DO or MBBS license required
ā¢ Strong written communication skills
Education/Experience: Associates degree in Nursing or equivalent experience. 4+ years of DRG and/or Medical Record Audit experience. One year of experience in a clinical setting or acute care hospital. Training or auditing experience in a managed care or healthcare setting.
Required License/Certification: RN, PA, MD, APRN, DO or MBBS license required
Preferred License/Certification: Valid/Current CPC or CIC Certification, through APPC desired or CCS through AHIMA; RHIA/RHIT Credentials desired.
Pay Range: $55,100.00 - $99,000.00 per year
Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act
Apply Now
Apply Now