Remote Clinical Quality Support Specialist

Chenega Corporation

1d•$18 - $22•Remote

About The Position

Come join a company that strives for Extraordinary People and Exceptional Performance! Chenega Services & Federal Solutions, LLC, a Chenega Professional Services’ company, is looking for a fully remote Clinical Quality Support Specialist to provide non-clinical support to the Clinical Quality Management Department. Obtains medical documents required to support all Clinical Quality Dept. processes. Ensures accuracy of identifying, and confirming current source, and method to retrieve medical records. Creates cases in Medical Management System, and prioritizes work based on expedited requests. Manages incoming and outgoing correspondence. Examines, evaluates and uploads incoming document contents and routes to assigned workgroup/person. Our company offers employees the opportunity to join a team where there is a robust employee benefits program, management engagement, quality leadership, an atmosphere of teamwork, recognition for performance, and promotion opportunities. We actively strive to channel our highly engaged employee’s knowledge, critical thinking, innovative solutions for our clients.

Requirements

High School Diploma or G.E.D. required associate’s degree in business or administration preferred
2+ years’ experience in in a medical office, health insurance, or managed care organization.
Proficient with Microsoft Office Suite
Ability to work in multiple software programs
Experience in medical records department
Knowledge of medical terminology, healthcare billing or medical claims processing
General knowledge of Medicare, TRICARE, or other government healthcare programs
Fully Remote must have access to high speed internet

Responsibilities

Maintains all CQM department files to meet TriWest confidentiality and security requirements
Obtains medical documents needed to support all Clinical Quality Dept. processes: PQI/PSI, Studies, TQMC and Committee work.
Accurately completes medical record requests in a timely manner.
Makes outbound calls to providers/hospitals to confirm process for requesting medical records
Completes and transmits electronic or word document medical records request form(s)
Builds cases in Medical Management system and tasks accordingly
Maintains tracker and monitors calendar timelines and deadlines for record retrieval
Identifies potential discrepancies in the medical management system to assure quality compliance.
Prepares, and distributes materials to members for clinical quality meetings
Participates in department meetings and work groups, serving on quality improvement committees as needed
Other duties as assigned