Quality Coordinator

Advocate Aurora Health; Milwaukee (WI); Remote; USD 50,000 - 80,000; Full time

Job summary

An established industry player is seeking a detail-oriented professional to oversee internal audits and quality improvement activities. This 100% remote position requires strong analytical skills and experience in credentialing within healthcare settings. You will collaborate with various teams to enhance auditing standards and maintain quality assessment information. Your role will involve managing data entry processes and ensuring compliance with established standards. Join a dynamic team where your contributions will significantly impact the quality of healthcare services provided to the community.

Qualifications

• 5-6 years experience in credentialing within an acute care or managed care environment.
• CPCS certified or eligible to sit for exam.

Responsibilities

• Oversees internal audit and continuous quality improvement activities.
• Maintains quality assessment information and recommends improvements.
• Manages data entry and ensures clean and consistent data.

Skills

PC Skills

Data Entry

Communication Skills

Analytical Skills

Teamwork

Education

Associate Degree in Business or Health-related Field

Tools

Microsoft Access

Microsoft Excel

Microsoft Word

Microsoft PowerPoint

Scanning Equipment

Job description

Department:

10117 Advocate Aurora Health Corporate - Credentials Verification Service

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

100% remote position, full-time days

Major Responsibilities:

1. Oversees internal audit and continuous quality improvement activities, policies, and procedures.
2. Contributes to the development of auditing and quality standards for timeliness, accuracy, and method and source.
3. Maintains and tracks quality assessment information in collaboration with Manager and Supervisor, with recommendations for improvements, including monthly dashboards, analysis, and corrective action plans.
4. Oversees reports and monitors turnaround time for analysis and action in collaboration with Manager and Supervisor.
5. Initiates audit and error reports for internal quality committee analysis and recommendations, requests new reports from Data Analysts, and tracks as appropriate.
6. Serves on the internal quality committee with Director, Manager, and Supervisor.
7. Collaborates with Manager and Supervisor on report generation by Data Analysts and assists in performance analysis for improvement.
8. Creates and maintains customer concern reports and acts on them as per policies and quality committee recommendations.
9. Creates and maintains minutes of internal quality committee, Credentials Committee, and Staff Meetings.
10. Performs ongoing monitoring of Medicare and Medicaid sanctions, reporting results to Compliance and internal credentialing customers.
11. Audits initial applications of credentialing coordinators against database standards.
12. Responsible for contract maintenance and verifications from outside sources, including fee-based verification processes.
13. Maintains contracts for outside source verifications such as CertiFacts, AMA Masterfile, NTIS, and others.
14. Submits documentation of outside source payments and creates quarterly bills for internal customers.
15. Manages data entry and oversees data convention adherence to ensure clean and consistent data.
16. Runs regular data audit reports for expirables and collaborates with relevant staff for updates.
17. Initiates database changes and updates for sensitive data.
18. Manages practitioner report card data, including malpractice history and other reports.
19. Coordinates special data entry/change projects and provides administrative support to departmental leadership.

Education/Experience Required:

• Associate Degree or equivalent in business or health-related field.
• 5-6 years experience in credentialing within an acute care or managed care environment.

Knowledge, Skills & Abilities Required:

• PC Skills (word processing, data entry, email, etc.)
• Access, Excel, Word, and PowerPoint skills preferred.
• Scanning equipment, FAX, copier, etc.
• CPCS certified or eligible to sit for exam.

Physical Requirements and Working Conditions:

• Local travel
• Experience working with physicians
• Ability to sit for extended periods
• Excellent attendance and punctuality record
• Ability to communicate verbally
• Ability to use a computer and enter data for extended periods
• Ability to organize and professionally manage demanding workload
• Assertiveness/political intuitiveness
• Demonstrated team player and self-motivated
• High-stress and demanding nature of the job

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities. Incumbent may be required to perform other related duties.