At HCSC, we consider our employees the cornerstone of our business and the foundation to our success. We enable employees to craft their career with curated development plans that set their learning path to a rewarding and fulfilling career.

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Job Summary

Under Supervision, This Position Is Responsible For Ensuring The Accuracy Of Auditing And Data Entry Within The Credentialing Department; Documenting Quality Performance Audits, Maintaining Quality Assurance Statistics; Analyze Error Reports, Determine Why Data Will Not Feed Into The System, And Determine Training Needs; And Provide Training To Others As Needed.

Responsibilities

1. Analyze error reports of information that is not accepted by system, determine why data will not feed into the system, directly work with employees to train them on errors, and determine errors and suggestions for training to present to training developers. 2. Perform Quality on Quality (QoQ); Handle the Rebuttal process to include communicating with disgruntle employees regarding data/process errors or scores. 3. Learn and maintain knowledge of system(s), how systems work and outcome/reports produced. 4. Audit/review data input to improve performance and accurate reporting statistics. Conduct analysis and ensure accuracy of information entered from documentation into systems. 5. Maintain good rapport with the System Support team for assistance with system interface issues. 6. Identify staff training needs during quality audits. Suggest ways to improve performance as it relates to quality and training. 7. Document quality performance and maintain quality assurance statistics; document error findings and refer identified performance issues to supervisor for review. 8. Develop solutions for better quality control, implement changes and assist in the development of enhanced procedures. 9. Maintain up-to-date process manual, reference materials, and training tools. 10. Perform in-depth investigation to ensure Corporate and Departmental Compliance Policies are adhered to. 11. Provide training to new employees in department on all functions. 12. Perform miscellaneous functions in support of the area and act as back up reporting activities. 13. Communicate and interact effectively and professionally with co-workers, management, customers, etc. 14. Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies. 15. Maintain complete confidentiality of company business. 16. Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.

JOB REQUIREMENTS: * High school diploma or GED. * 3 years business experience. A combination of college level education and experience will be considered * Quality audit experience * Clear and concise interpersonal, verbal and written communication skills to facilitate the learning process; coaching and mentoring skills * PC experience in Windows, Word, Excel, Access, and other business related/associated databases. * Demonstrated analytical and organizational skills * Knowledge of Managed Care products, programs, and services. * Knowledge of managed care provider databases

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HCSC Employment Statement:

HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.