Quality Improvement Medical Records Specialist

Posting Details

About WesternU

As you take your first step onto a Western University of Health Sciences campus, each path, each person, each structure comes with a transformative story. WesternU is more than the practice of medicine. We are defined by character and culture.

At WesternU, you will discover humanism at the heart of every interaction : a warm welcome, a sincere smile, a positive word, a kind deed, a thoughtful gesture. You will see students work together on case studies; a parade of pets in campus parks; student clubs offering opportunities for career growth and community involvement; and faculty, staff and students designing their future and the future of WesternU. We display a collaborative mindset in how we operate, educate, and serve others.

Although, geographically, we are two campuses - as humanists, we are one : to enhance and extend the quality of life in our communities and achieve excellence in everything we do. We attract diverse, professional faculty, staff and students that thrive in an environment of humanistic health care education. Join our team of faculty and staff and make a difference.

Posting Details

Position Title

Quality Improvement Medical Records Specialist

Position Control Number

100555

Type of Position

Staff

Position Status

Full-time

Campus

Western University Campus-Pomona, CA

Position Location

California

Department

1313-Patient Care Center - PCC

Job Summary

To provide support services for medical records for WesternU Health. Appropriately and accurately verify and process requests for charts to be pulled for patient care, quality review, and audits in a timely manner. Release information to patients, healthcare facilities and

other entities with following all laws and regulations including HIPAA. In addition, supports the Quality Improvement team with HEDIS, Stars, P4P and Risk Adjustment activity functions related to outreach, collection and accurate data entering of medical records and service data, according to NCQA HEDIS / STARS and CMS Medicare Advantage guidelines.

The Quality Improvement Medical Record Specialist coordinates internal / external data reports aimed in closing quality care gaps and supports internal staff with daily Quality Improvement tasks such as Gap / Care due list, filing, faxing, copying, and scanning of files, acts as a liaison for the department in routine administrative and project coordination activities, including conduct effective research to meet project goals and assigned task and attends to Health Plans, IPA / MSO, provider, and inter-departmental meetings.

Knowledge, Skills and Abilities

Individuals must possess the knowledge, as well as the following skills and abilities or be able to perform the essential functions of the job, with or without reasonable accommodation using some other combination of skills and abilities.

• Strong customer focus, interpersonal, collaboration, written / verbal communication, prioritization and computer skills.
• Must be able to establish daily work priorities and work efficiently to contribute to the successful overall maintenance of the credentialing process.
• Able to handle multiple simultaneous tasks and complete work projects in designed time frames.
• Demonstrated attention to detail and good organizational capability.
• Strong working knowledge of medical terminology including insurance credentialing.
• Experience working with Windows based applications : Excel, Word, and Outlook.
• Significant knowledge of State and Federal Regulatory requirements and accreditation standards, e.g., HIPAA, NCQA, NPDB, Title XXII, CAQH and NPPES.
• Considerable working knowledge of practice management applications.
• Ability to type, use a ten-key by touch, telephone, fax copier, scanning.

Required Qualifications

Preferred Qualifications

Preference will be given to candidates holding certification in the appropriate professional field and organizations.

Essential Job Duties

Key Responsibilities

Key Responsibilities

Key Responsibilities

Key Responsibilities

Posting Details Continued

Work Schedule

Working at WesternU

We believe in making an impact in the lives of our employees, personally, and professionally. Every employee has different individual and / or family needs. We offer benefits that are both comprehensive and flexible to address your unique needs. We believe work-life harmony is positive and achievable.

We offer competitive salaries, generous paid time off, insurance plans, reimbursements, and retirement benefits. Additionally,

Expected Pay Scale

Minimum

$23.00 Hourly

Maximum

$26.50 Hourly