Senior Premium Auditor conducting virtual reviews of complex commercial policyholder financial records. Collaborating directly with clients and delivering exceptional customer service in a fast - paced environment.
About the role
- Health Plans LPN Auditor conducting independent chart reviews for Arizona's health plans. Collaborating with facilities to ensure compliance with quality standards and regulations.
Responsibilities
- Independently review patient medical charts for compliance
- Provide feedback and assistance to facilities for compliance
- Perform quality medical record reviews and data analysis
- Monitor and track Corrective Action Plans (CAPs)
- Report potential risk or compliance issues
- Support continuous improvement in Medical Management
Requirements
- Current, unrestricted State of Arizona LPN license
- Two years of experience, preferably in a family practice or pediatric medical office setting
- Excellent verbal and written communication skills
- Strong collaborative skills
- Knowledge and understanding of HEDIS specifications
- Knowledgeable of NCQA, HEDIS, AHCCCS, and CMS standards and reporting requirements
Benefits
- Comprehensive benefit package
- Professional development opportunities
- Flexible work arrangements
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