- Bachelor's degree and 2 years' experience auditing claims, inquiry or experience in the health insurance industry OR 6 years' experience auditing claims, inquiry, or membership within the health insurance industry.
- Knowledge of contract administration, and medical terminology.
- Analytical and research skills.
- Clear and concise written and verbal communication skills.
- Organizational and multi-tasking skills to manage daily workload and meet aggressive deadlines and timetables.
- Knowledge of state contract provisions.
- PC proficiency to include Word, Excel, PowerPoint, Microsoft Teams, and WebEx
- Experience meeting deadlines.
- RADV, HEDIS or HCC auditing experience
- LPN or MA licensure or certification
- Certified Coder
- Quality audit experience
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Information Systems Specialist
2 weeks ago
KBR Tulsa, United StatesInformation Systems Specialist - Junior JNWC page is loaded · Information Systems Specialist - Junior JNWC · Apply · locations · Albuquerque, New Mexico · time type · Full time · posted on · Posted Yesterday · job requisition id · R · Title: · Information Systems Speci ...
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Information Assurance Specialist
1 week ago
KBR Tulsa, United StatesKBR Information Assurance Specialist - Intermediate JNWC Albuquerque , New Mexico Apply Now Information Assurance Specialist - Intermediate JNWCKBR is seeking an Information Assurance Specialist to join our team in Albuquerque, NM; You will provide advice and support to Joint Nav ...
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Information Security Specialist
1 week ago
Insight Global Tulsa, United StatesInsight Global Information Security Specialist Miami , Florida Apply Now My client is looking for an information security specialist that will be responsible for safeguarding the organization's computer systems and networks from cybersecurity threats. Their duties include monitor ...
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Information Entry Specialist
1 week ago
DMA Consulting Tulsa, United StatesJob Description · Job DescriptionAbout us: DMA Consulting is a dynamic, results-driven company that focuses on providing top-tier business consulting services to clients globally. We value innovative thinking, adaptability, and exceptional customer service. We believe in empoweri ...
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Information Assurance Specialist
1 week ago
KBR Tulsa, United StatesKBR Information Assurance Specialist - Junior JNWC Albuquerque , New Mexico Apply Now Information Assurance Specialist - Junior JNWCKBR is seeking an Information Assurance Specialist to join our team in Albuquerque, NM; You will provide advice and support to Joint Navigation Warf ...
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Specialist in Poison Information
1 week ago
SUNY Upstate Medical University Tulsa, United StatesSUNY Upstate Medical University Specialist in Poison Information Syracuse , New York Apply Now The Specialist in Poison Information will be responsible for providing toxicological management information to healthcare providers and to the public over the telephone; following up in ...
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FirstFour Staffing Tulsa, United StatesFirstFour Group, a leading provider of professional recruitment services, is currently seeking an experienced Network Infrastructure Technician for a global manufacturing enterprise. The role will be based onsite at their facility in metro Tulsa, Oklahoma. The client is willing t ...
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Information Systems Specialist Intermediate JNWC
2 weeks ago
KBR Tulsa, United StatesInformation Systems Specialist Intermediate JNWC · KBR is seeking an Information Systems Specialist - Intermediate to join our team in Albuquerque, NM; You will provide advice and support to Joint Navigation Warfare Center (JNWC) activities. · Responsibilities: · Support IT secur ...
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Information Systems Specialist Senior JNWC
2 weeks ago
KBR Tulsa, United StatesInformation Systems Specialist Senior JNWC · Qualifications: · KBR is seeking an Information Systems Specialist Senior to join our team in Albuquerque, NM; You will provide advice and support to Joint Navigation Warfare Center (JNWC) activities. · Responsibilities: · Coordinates ...
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CDL Driver
1 week ago
BAXTER Tulsa, United States Full timeVantive: A New Company Built On Our Legacy · Baxter is on a journey to separate our ~$5B Kidney Care segment into a standalone company. Vantive* will build on our nearly 70-year legacy in acute therapies and home and in-center dialysis to provide best-in-class care to the people ...
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CDL Driver
2 weeks ago
BAXTER Tulsa, United States Full timeVantive: A New Company Built On Our Legacy · Baxter is on a journey to separate our ~$5B Kidney Care segment into a standalone company. Vantive* will build on our nearly 70-year legacy in acute therapies and home and in-center dialysis to provide best-in-class care to the people ...
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Information Technology Specialist
1 week ago
Indian Health Service Claremore, United States Full timeIncumbent serves as a local specialist on hardware, software, telephony application programs and assists in the support of the hospital LAN. At the direction of the CIO, install new IT technology, provide consultation, technical support, train end users, and be on call when neede ...
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Information Technology Infrastructure Specialist
3 weeks ago
Action Group Staffing Catoosa, United StatesAction Group is currently assisting an international manufacturing client in the Port of Catoosa in their search for an IT Infrastructure Specialist. · The ideal candidate will have at least two years' experience creating and managing IT infrastructure in a manufacturing environm ...
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Apex Ventures Inola, OK, United States FreelanceWe are seeking individuals to join our team in **Inola, OK** · **SUMMARY** · As a member of our team, you will provide Community Information Services for Army Community Service. This includes offering customer service at the front desk by greeting customers in person and over the ...
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NovaTech Solutions Turley, United States"Join our Guardian Angel team and start your career with the market leader in insurance in our region, at the Carstensen and Friedrichsen district office in Niebuell. We offer excellent prospects in a crisis-proof job. Here's what you can expect: * A diverse profession with a fut ...
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Environmental Specialist I
3 weeks ago
CYB Human Resources Owasso, United StatesSeeking a Planning/Environmental Specialist to provide assistance with the preparation of planning and environmental studies and NEPA documentation for various infrastructure projects across multiple business lines. · Geographic information systems (GIS) analysts manage and lever ...
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Cardiovascular / EP Specialist
1 day ago
Hillcrest Hospital South Tulsa, United StatesJob Description · Overview · Join our team as a day shift, full-time, Cardiovascular Specialist in Tulsa. · Fulfilling your purpose begins here: · People First, Always. Here's how we take care of our people: · Medical, vision, dental health insurance, health savings account / ...
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Document Control Specialist
3 weeks ago
Trinity Employment Specialists Tulsa, United StatesDocument Control Specialist · Trinity Employment Specialists-Tulsa, OK 74135 · Full Time| Monday-Friday | $21.25/hour · Summary: · Document Control Specialist will work closely with Manufacturing Technician's to produce standard work instructions, including set up sheets and in p ...
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Denial Specialist II
3 weeks ago
BCforward Tulsa, United StatesDenial Specialist II · BC Forward is looking for Denial Specialist II (Remote Work) · Position Title: Denial Specialist II (Remote Work) · Mode Of Work: Remote (EST OR CST) · Locations: 322 E Archer St, Tulsa, OK 74120 · Anticipated Start Date: 6/11 · Expected Duration: 6 month ...
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Denial Specialist II
1 week ago
BCforward Tulsa, United StatesDenial Specialist II · BC Forward is looking for Denial Specialist II (Remote Work) · Position Title: Denial Specialist II (Remote Work) · Locations: Remote-Oklahoma (Only Local to OK) · Anticipated Start Date: 6/3 · Expected Duration: 6 months. · Job Type: Contract with possibl ...
Health Information Specialist - Tulsa, United States - Health Care Service Corporation
Description
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.
Come join us and be part of a purpose driven company who is invested in your future
Job Summary
This position is responsible for the quality and efficiency of the clinical quality review process associated with the CMS HHS_RADV (Risk Audit Data Validation) program for ACA plans and HEDIS (Healthcare Effectiveness Data and Information Set). Analysts are responsible for ensuring a successful audit including verifying provider information, medical record retrieval, conducting medical chart reviews on encounters and validating HCC's which have been submitted via claims data, identifying erroneous data and initiate corrections needed, submitting the final audited record to the coding team, and tracking the entire process.
REQUIRED JOB QUALIFICATIONS:
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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.
Health Information Specialist professionals in Tulsa
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Tom Madigan
Supply Chain Professional
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Melinda Elliott
RN Care Manager