Quality Improvement Specialist I

Position Title : Quality Improvement Specialist I

Work Location : Remote - Texas only

Assignment Duration : 3 months (Possibility of extension)

Work Schedule : 8-5, no OT

Work Arrangement : Fully Remote (Texas residents only)

Key Responsibilities :

• Primarily on the phone / emailing with medical offices / facilities confirming members and requesting medical records
• Documenting work in web portal and internal applications
• Performing claims research internally and web / google research to find most up-to-date provider information
• Other projects as assigned including work in Excel, OneDrive & Teams

Qualification & Experience :

Education / Certification

Required : high school diploma or GED

Preferred : Licensure

Required : Preferred :

Years of experience required :

Disqualifiers : Coder or Abstractor - HEDIS or otherwise. This is NOT a coding position. This is a phone / email outreach & web research position.

Additional qualities to look for : Medical Office experience, Medical Records Clerk

Customer Service Experience - on the phone or in person - must be comfortable calling provider offices

Good computer skills with more than Beginner Excel

Ability to work independently with minimal supervision / structure