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Summary

Come join a company that strives for _Extraordinary People and Exceptional Performance_ ! **Chenega Services & Federal Solutions, LLC,** a **Chenega Professional Services** ’ company, is looking for a fully remote **Clinical Quality Support Specialist** to provide non-clinical support to the Clinical Quality Management Department. Obtains medical documents required to support all Clinical Quality Dept. processes. Ensures accuracy of identifying, and confirming current source, and method to retrieve medical records. Creates cases in Medical Management System, and prioritizes work based on expedited requests. Manages incoming and outgoing correspondence. Examines, evaluates and uploads incoming document contents and routes to assigned workgroup/person.

Our company offers employees the opportunity to join a team where there is a robust employee benefits program, management engagement, quality leadership, an atmosphere of teamwork, recognition for performance, and promotion opportunities. We actively strive to channel our highly engaged employee’s knowledge, critical thinking, innovative solutions for our clients.

Responsibilities

+ Maintains all CQM department files to meet TriWest confidentiality and security requirements

+ Obtains medical documents needed to support all Clinical Quality Dept. processes: PQI/PSI, Studies, TQMC and Committee work.

+ Accurately completes medical record requests in a timely manner.

+ Makes outbound calls to providers/hospitals to confirm process for requesting medical records

+ Completes and transmits electronic or word document medical records request form(s)

+ Builds cases in Medical Management system and tasks accordingly

+ Maintains tracker and monitors calendar timelines and deadlines for record retrieval

+ Identifies potential discrepancies in the medical management system to assure quality compliance.

+ Prepares, and distributes materials to members for clinical quality meetings

+ Participates in department meetings and work groups, serving on quality improvement committees as needed

+ Other duties as assigned

Qualifications

+ High School Diploma or G.E.D. required associate’s degree in business or administration preferred

+ 2+ years’ experience in in a medical office, health insurance, or managed care organization.

+ Proficient with Microsoft Office Suite

+ Ability to work in multiple software programs

_Knowledge, Skills and Abilities:_

+ Experience in medical records department

+ Knowledge of medical terminology, healthcare billing or medical claims processing

+ General knowledge of Medicare, TRICARE, or other government healthcare programs

Teleworking Permitted?

Yes

Teleworking Details

Fully Remote must have access to high speed internet

Estimated Salary/Wage

USD $18.00/Hr. Up to USD $22.00/Hr.

Chenega Corporation and family of companies is an EOE.

Equal Opportunity Employer/Veterans/Disabled

Native preference under PL 93-638.

We participate in the E-Verify Employment Verification Program