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Quality Control Executive (5009)

Remote: 
Full Remote
Contract: 
Full time
Experience: 
Entry-level / graduate
Work from: 
United States

Offer summary

Qualifications:

High School Diploma or GED required, Effective communication skills in English, Administrative and back-office experience preferred, Proven customer service experience, Familiarity with HIPAA regulations.

Key responsabilities:

  • Verify member information in medical records
  • Highlight diagnoses and page types
  • Address error reports timely and efficiently
  • Maintain quality, accuracy, and efficiency
  • Report job-related events to supervisor
Advantmed logo
Advantmed Large https://www.advantmed.com/
1001 - 5000 Employees
About Advantmed
Advantmed is a privately held company founded in 2005. The organization initially focused on record retrieval but has evolved into an innovative healthcare information management company that helps health plans and Managed Care Organizations optimize revenue and improve quality outcomes. Our mission is to improve the healthcare system by ensuring appropriate, quality care and eliminating unnecessary costs. We accomplish this by providing a cost-effective suite of capabilities tailored to the unique needs of our clients, including NCQA-certified HEDIS® measure software, risk analytics, medical record retrieval, medical record abstraction, risk adjustment coding, data validation, prospective assessments, and provider education. Our strategy reflects our flexibility and commitment to meeting our clients' evolving needs. We work closely with our clients to understand their concerns, requirements, strategic objectives, and infrastructure so that we can support them accordingly. Our foundational principles are accuracy, efficiency, and transparency. Our solutions are designed to be user-friendly and flexible. We see ourselves as an extension of our clients’ internal teams, which allows us to work to advance our solutions and provide support for their growing business needs. Understanding how our clients use our products and services fuels our product development road map, especially in terms of technology as we continually work to improve our client portal. In addition, we regularly monitor statutory and regulatory changes from CMS, HHS, NCQA, and others. The Advantmed leadership team is composed of seasoned healthcare veterans, with extensive quality and risk adjustment expertise. The leadership team oversees a global staff of over 1,800 employees. Notably, we are HITRUST certified, and all data resides within the United States.
See more Advantmed offers

Job description

  • Understand/recognize valid medical records for each process assigned
  • Read the valid documents and verify the member information considering all possibilities
  • Highlight diagnosis and identify correct page type according to procedure
  • Go through respective error reports on a priority basis; understand the feedback and make sure the errors are not getting repeated
  • Achieve productivity target on a daily basis for all the projects assigned
  • Maintain required quality/accuracy/efficiency on a consistent basis for all the projects assigned
  • Be part of a silent work atmosphere to help oneself as well as the team to perform better
  • Report to supervisor on all the job-related events

Requirements

Qualifications: 

  • A High School Diploma or GED is required. 
  • Must be able to communicate effectively in the English language. 
  • Administrative experience in Work from home; previous back-office experience release of information/medical records, or other related experience in a healthcare environment is preferred. 
  • Proven customer service experience and/or training. 
  • Ability to effectively use computer software and technology as per business needs including Microsoft Word and Excel 
  • Ability to understand and become knowledgeable of record retrieval process, policies and HIPAA regulations and to complete work in compliance of these and other standards. 
  • Ability to read and comprehend simple, healthcare terminology 
  • Effective verbal and written communication skills. 
  • Effective organizational skills a must 
  • Advantmed will supply selected candidates with the necessary systems and headphones for carrying out this role. 

Required profile

Experience

Level of experience: Entry-level / graduate
Spoken language(s):
EnglishEnglish
Check out the description to know which languages are mandatory.

Hard Skills

Front And Back Office ApplicationProductivity ManagementAdministrative SupportHealth Care Finance Administration (HCFA) RegulationsException ReportingMedical TerminologyMedical Record Management

Other Skills

  • Detail Oriented
  • Customer Service
  • Verbal Communication Skills
  • Organizational Skills
  • Microsoft Excel
  • Microsoft Word
Are you interested?

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