Quality Control Specialist

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🔥 0 minutes ago

🌽 Illinois, Texas – Remote

🌽 Illinois – Remote 🤠 Texas – Remote

💵 $22 - $40 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 0%

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Health Care Service Corporation

WebsiteLinkedInAll Job Openings

10,000+ employees

🛡️ Insurance

💼 Consulting

🏥 Healthcare

Insurance • Consulting • Healthcare

Health Care Service Corporation is an independent licensee of the Blue Cross Blue Shield Association, serving nearly 23 million people across the United States with a wide range of health benefit solutions. The company provides health coverage options for various groups, including employers, individuals, families, as well as Medicare and Medicaid plans. In addition to health insurance, HCSC offers services such as pharmacy solutions, life and dental insurance, and health data technology. With nearly a century of experience, HCSC is dedicated to improving access to quality care, enhancing health outcomes, and reducing costs while maintaining a deep commitment to its members and local communities.

📋 Description

• Ensure accuracy of auditing and data entry for assigned states • Document quality performance audits • Maintain quality assurance statistics • Provide training as needed • Research and analyze medical records when coding discrepancies are identified • Validate coding accuracy • Support reporting of audit findings

🎯 Requirements

• High school diploma or GED • 2 years’ business experience • A combination of college level education and experience will be considered • Clear and concise interpersonal, verbal and written communication skills • Coaching and mentoring skills • PC experience in Windows, Word, Excel, Access, and other business-related/associated databases • Demonstrated analytical and organizational skills • Current certifications - CPC, CCS-P, CCS, or CRC (risk adjustment coder) (preferred) • 2 years’ risk adjustment coding experience (preferred) • Experience reviewing medical record information to identify appropriate coding based on CMS Coding Guidelines and/or Official ICD9/ICD10 Coding Guidelines (preferred) • Experience providing coding and documentation best practices to providers/clinicians and business partners (preferred) • Ability to travel 20%–30% of the time in and out of state (preferred)

🏖️ Benefits

• Curated development plans and professional development opportunities • 401(k) savings plan • Pension plan • Paid time off • Paid parental leave • Disability insurance • Supplemental life insurance • Employee assistance program • Paid holidays • Tuition reimbursement • Other incentives • Annual incentive bonus plan subject to plan terms and conditions • Remote work from home

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