LPN Auditor

Job not on LinkedIn

🔥 17 hours ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $28 - $47 / hour

⏱ Part Time

🟢 Junior

🟡 Mid-level

🔎 Auditor

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

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Banner Health

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1999

🏥 Healthcare

⚕️ Healthcare Insurance

Healthcare • Healthcare Insurance

Banner Health is a leading healthcare system committed to making healthcare easier through comprehensive patient services and resources. They provide a safe place for care with services ranging from emergency and urgent care, imaging, and surgery centers to maternity and hospice care. Banner Health also offers telehealth options to ensure access to healthcare, regardless of location. They support athletes through Banner Orthopedics & Sports Medicine and have been recognized for exceptional patient care. With advanced digital tools, they aim to manage healthcare seamlessly for their patients.

📋 Description

• Independently triage incoming referrals, manage case assignments, and oversee cases through resolution • Coordinate and perform quality medical record reviews for PCPs, OBGYNs, and High Volume Specialists • Assist the QM RN with investigation and research of quality-of-care concerns • Abstract medical records, analyze data, and import data to satisfy contract requirements and organizational initiatives • Develop clinical medical record audit tools and processes • Conduct data analysis using Microsoft Excel and data from ManagedCare.com, TCS, medical records, and survey tools • Retrieve and perform medical record audits to determine provider compliance with AHCCCS documentation standards • Monitor and track Corrective Action Plans and communicate audit results and best-practice recommendations to providers • Provide written documentation and Corrective Action Plans and coordinate with the Credentialing Department • Report potential risk or compliance issues and assist with QM policies and procedures • Aggregate and analyze annual medical record audit results for OFR-required data • Prepare monthly provider profile data reports for the Credentialing Department • Abstract and assist with analysis of medical-record data according to HEDIS specifications • Collaborate with the HEDIS team on performance measures, methodology, and processes • Create datasets and databases for quality, medical management, and departmental studies • Support continuous improvement and complete assigned AHCCCS review work-plan tasks

🎯 Requirements

• Current, unrestricted State of Arizona LPN license • Two years of experience, preferably in a family practice or pediatric medical office setting • Ability to travel to all contracted sites, which may necessitate occasional overnight stays • Ability to work independently and as part of an interdisciplinary team • Excellent verbal and written communication skills • Strong collaborative skills • Attention to detail and accuracy • Knowledge and understanding of HEDIS specifications • Strong leadership, problem-solving, and investigative skills • Ability to maintain strict confidentiality • Ability to prioritize workload in a fast-paced environment • Ability to implement standards, data sources, research tools, and data collection instruments • Ability to collect, analyze, describe, and evaluate data and write reports • Ability to implement and track process-improvement effectiveness • Ability to recognize risk-management concerns • Ability to review and extract significant data from medical records • Knowledge of NCQA, HEDIS, AHCCCS, and CMS standards and reporting requirements

🏖️ Benefits

• Comprehensive one-on-one training provided by experienced investigators • Remote work opportunity • Note: Banner Staffing Services roles do not offer medical benefits or paid time off accrual • Assignment-based role with no guarantee of hours

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