[Hiring] Clinical Quality Support Specialist @TriWest Healthcare

Role Description

This position works under the direction of the Manager, Clinical Quality to provide non-clinical support for the Clinical Quality Department. Responsibilities include:

• Managing incoming and outgoing correspondence.
• Preparing documents and compiling data for meetings and workgroups.
• Tracking and conducting follow-up to obtain requested documents for PQI review or focused studies.

Qualifications

• High School Graduate or G.E.D.
• 3+ years administrative experience or equivalent.
• Experience in a medical office, health insurance, or managed care organization.
• Proficient with Microsoft Excel, Word, Outlook.
• Ability to work in multiple software programs.
• Associates Degree in Business or Administrative Services (Preferred).
• Medical terminology (Preferred).
• Microsoft OneNote experience (Preferred).
• Letter writing experience (Preferred).

Requirements

• Orders/receives medical records for Potential Quality Issues (PQI and CQM Department activities according to desk procedures).
• Conducts follow-up telephone calls to providers and completes other processes to resolve missing documents.
• Obtains, prepares, and distributes materials for quality meetings, workgroups, and projects as directed.
• Maintains all CQM department files to meet TriWest confidentiality and security requirements.
• Processes invoices for medical records received and follows up with the Finance/Accounting Dept. as needed.
• Processes incoming and outgoing mail and faxes, correspondence for overnight or certified delivery, and other mailing needs.
• Participates in department meetings and work groups, serving on quality improvement committees as needed.
• Performs other duties as assigned.
• Regular and reliable attendance is required.
• Supports department activities for Provider Credentialing Committee.

Benefits

• Medical, Dental and Vision Coverage.
• Paid time off.
• 401(k) Retirement Savings Plan (with matching).
• Short-term and long-term disability, basic life, and accidental death and dismemberment insurance.
• Tuition reimbursement.
• Paid volunteer time.
• Frequent pay raises and overtime opportunities.
• Recognition and reward programs.
• Salary range typically from around $42,660 - $47,400 per year.