Quality Control Specialist - Work from Home

Health Care Service Corp.; Chicago (IL); Remote; USD 31,000 - 56,000; Full time

Benefits offered by this job

Work from home

Travel opportunities

Job summary

Health Care Service Corporation (HCSC) is seeking a quality-focused auditor to ensure audit accuracy and data entry for assigned states, documenting QA statistics and training teams as needed.

Responsibilities include researching medical records, validating coding accuracy, and supporting audit reporting. Remote work options and travel 20–30% are part of the role.

Qualifications

• High school diploma or GED required.
• 2 years’ business experience required.
• College coursework with experience considered.
• Clear, concise communication skills; coaching/mentoring abilities.
• Proficient in Windows, Word, Excel, Access and related databases.
• Demonstrated analytical and organizational skills.

Responsibilities

• Ensure auditing and data entry accuracy for assigned states.
• Document quality performance audits and maintain QA statistics.
• Provide training as needed and support reporting of audit findings.
• Research and analyze medical records for coding discrepancies and validate accuracy.

Skills

Interpersonal communication

Coaching and mentoring

Analytical skills

Organizational skills

Attention to detail

Education

High school diploma or GED

College coursework + experience considered

Tools

Windows

Word

Excel

Access

Job description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers. Join HCSC and be part of a purpose-driven company that will invest in your professional development.

Job Summary

Under supervision, this position is responsible for ensuring the accuracy of auditing and data entry for assigned states; documenting quality performance audits, maintaining quality assurance statistics; and providing training as needed. In addition, this role researches and analyzes medical records when coding discrepancies are identified, validates coding accuracy, and supports reporting of audit findings.

Job 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 to facilitate the learning process; coaching and mentoring skills.
• PC experience in Windows, Word, Excel, Access, and other business related/associated databases.
• Demonstrated analytical and organizational skills.

Preferred Job Requirements

• Current certifications - CPC, CCS-P, CCS, or CRC (risk adjustment coder).
• 2 years’ risk adjustment coding experience.
• Experience reviewing medical record information to identify all appropriate coding based on the CMS Coding Guidelines and/or Official ICD9 / ICD10 Coding Guidelines.
• Experience providing coding and documentation best practices to providers/clinicians and business partners.

Ability To Travel

20% – 30% Of the Time in and out of State

Telecommute Role

(Work from Home) #LI - RR1 #LI - Remote

Are you being referred to one of our roles? If so, ask your connection at HCSC about our Employee Referral process!

Pay Transparency Statement

At Health Care Service Corporation, you will be part of an organization committed to offering meaningful benefits to our employees to support their life outside of work. From health and wellness benefits, 401(k) savings plan, pension plan, paid time off, paid parental leave, disability insurance, supplemental life insurance, employee assistance program, paid holidays, tuition reimbursement, plus other incentives, we offer a robust total rewards package for employees. Learn more about our benefit offerings by visiting https://careers.hcsc.com/totalrewards. The compensation offered will vary depending on your job-related skills, education, knowledge, and experience. This role aligns with an annual incentive bonus plan subject to the terms and the conditions of the plan. This position may be performed remotely from anywhere within the continental United States, excluding California, New York, Alaska, and Hawaii.

Employment Statement

We are an Equal Opportunity Employment employer dedicated to providing a welcoming environment where the unique differences of our employees are respected and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics. We are a drug-free and smoke-free workplace. Employment may be contingent upon successful completion of drug screening in accordance with applicable law.

Base Pay Range $22.54 - $40.31 Exact compensation may vary based on skills, experience, and location.

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For more than 80 years, HCSC has been dedicated to expanding access to high-quality, cost-effective health care and equipping our members with information and tools to make the best health care decisions for themselves and their families. As an industry leader, HCSC also has been helping to make the health care system work better for all Americans. To remain a leader, we offer compelling careers that encourage resourcefulness, strategic thought and empower you to make a difference in the lives of our members and their communities. Today, with the industry at an important crossroad, HCSC is reimagining health care and looking for original thinkers who aren’t afraid to make innovative contributions. We are an Equal Opportunity Employment employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Learn more about HCSC, our commitment to our members and the opportunity you’ll have to improve health care delivery in an open, collaborative environment.

HCSC is committed to diversity in the workplace and to providing equal opportunity to employees and applicants.

If you are an individual with a disability or a disabled veteran and need an accommodation or assistance in either using the Careers website or completing the application process, you can call us at 1-866-977-7378 to request reasonable accommodations. Please note that only requests for accommodations in the application process will be returned. All applications, including resumes, must be submitted through HCSC's Career website on-line application process. If you have general questions regarding the status of an existing application, navigate to "candidate home" to view your job submissions.