Remote HEDIS Quality Audit Nurse (RN) – 6 Months

Spectraforce Technologies; Nashville (TN); Remote; USD 70,000 - 85,000; Full time

Job summary

Spectraforce Technologies is seeking a Quality Audit Specialist (RN) for a remote 6-month assignment. The role focuses on abstraction of medical records for HEDIS, with accurate data entry into healthplans databases.

The ideal candidate holds an RN license, has 3+ years of relevant experience in quality assurance or audits, and is proficient in Word and Excel. Remote work nationwide; HIPAA and policy compliance are essential.

Qualifications

• Registered Nurse (RN) with unrestricted license in state.
• 3+ years relevant experience in audits or utilization review.
• Experience in quality assurance and medical record audits.
• Knowledge of medical terminology and federal/state regulations.
• Verbal and written communications skills.
• Proficient in Word and Excel.

Responsibilities

• Apply structured auditing criteria to abstract medical records and enter results into the healthplans database.
• Abstract medical record documentation for HEDIS measures used for NCQA reporting.
• Maintain productivity with under 5% error rate in record abstraction and data entry.
• Comply with HIPAA and corporate policies.
• Maintain confidentiality of company information and communicate with management.

Skills

Communication skills

HIPAA knowledge

Medical record abstraction

PC proficiency (Word, Excel)

Education

RN with unrestricted license (US)

Licensed Practical Nurse

Tools

Word

Excel

Job description

Spectraforce Technologies is seeking a Quality Audit Specialist (RN) for a remote 6-month assignment. The role focuses on abstraction of medical records for HEDIS, with accurate data entry into healthplans databases.

The ideal candidate holds an RN license, has 3+ years of relevant experience in quality assurance or audits, and is proficient in Word and Excel. Remote work nationwide; HIPAA and policy compliance are essential.