QI Specialist - Chico Area, Butte, Placer, and Yuba Counties - PS1180

QI Specialist - Chico Area, Butte, Placer, and Yuba Counties - PS1180
Location: California, United States
Field: Business Support
Requisition #: PS1180
Post Date: Feb 28, 2018
_Your Talent. Our Vision._ At Anthem Blue Cross , a proud member of the Anthem, Inc. family of companies, it?s a powerful combination, and the foundation upon which we?re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care . This is an exceptional opportunity to do innovative work that means more to you and those we serve.
Location: Work from home, but you must reside in Butte, Placer, and Yuba counties
The QI Specialist is responsible for performing and/or documenting quality reviews bases on departmental procedures and contributes to standardizing the quality review approach to be in compliance of contractual, State, and Federal requirements.
Primary duties may include, but are not limited to:
+ Focuses on identifying, recommending and implementing a standardized approach to performing and scoring quality audits.
+ Examines and evaluates the accuracy of transactions processed by reviewing policy, procedure and manual input in accordance with guidelines.
+ Tracks, trends and reports audit results to management. Identifies and communicates training issues and assists in developing corrective action plans.
+ Runs and monitors monthly reports from database to identify and/or correct any incorrect data..
+ Requires a High School diploma or GED; 5 years of experience in health care, medical terminology and coding, 2-3 years of related experience; or any combination of education and experience, which would provide an equivalent background
_Anthem, Inc. is ranked as one of America?s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran._

Don't Be Fooled

The fraudster will send a check to the victim who has accepted a job. The check can be for multiple reasons such as signing bonus, supplies, etc. The victim will be instructed to deposit the check and use the money for any of these reasons and then instructed to send the remaining funds to the fraudster. The check will bounce and the victim is left responsible.