• Expertini Resume Scoring: Our Semantic Matching Algorithm evaluates your CV/Résumé before you apply for this job role.
United States Jobs Expertini

Clinical Operations QA Specialist Job Opening In remote us – Now Hiring Reveleer


Job description

Clinical Operations QA Specialist
Remote

Reveleer is a healthcare data and analytics company that uses Artificial Intelligence to give health plans across all business lines greater control over their Quality Improvement, Risk Adjustment, and Member Management programs.

With one transformative solution, the Reveleer platform enables plans to independently execute and manage every aspect of enrollment, provider outreach and data retrieval, coding, abstraction, reporting, and submissions.

Leveraging proprietary technology, robust data sets, and subject matter expertise, Reveleer provides complete record retrieval and review services so health plans can confidently plan and execute risk, quality, and member management programs to deliver more value and improved outcomes.

As a Clinical QA Specialist, you will be responsible for ensuring all clinical resources are monitored to meet quality scores based on QA standards set by the organization.

Your responsibilities also include providing support to clinical QA and Training team to deliver excellent quality and productivity outcome.

The ideal candidate is detail-oriented, able to work independently and at the same time able to collaborate with team members and staff.

Ideal candidate will demonstrate initiative and leadership in designing new QA protocols and QA policies in the bounds of Reveleer clinical operations and serves as subject matter expert and support to staff at all levels throughout the organization..

Essential Functions:

  • Completes overread of chases for coders in production and provides support in completing initial QA process during onboarding.
  • Communicates with and provides feedback to the Training and QA team of coding error trends and assist in creating action plans to mitigate QA discrepancies.
  • Assists coders in resolving coding queries based on Reveleer Coding Guidelines, AHA Coding Clinics, CMS Coders Guidance on Medical Review.
  • Create and maintain quality control activities: Bi-monthly quality check on performance, monthly quality assurance reviews, keeping track of QA scores and make sure that all corrections are done in a timely manner.
  • During the bi-monthly quality checks – able to identify outliers that needs retraining and set action plans and communicated either on one-on-one or group teaching in coordination with the training team.
  • Pulls reports to better understand error trends and present to internal team for deliberation.
  • Collaborate and consult effectively with all levels of the QA teams to ensure adherence to policies and procedures.
  • Well-versed and Knowledgeable on Microsoft Office applications (Excel, Word, Powerpoint) as well as Adobe Pro and use these applications to handle communication within the clinical team.
  • Additional duties as necessary to meet our obligations to our customers.
  • Core Competencies:

  • Caring – Warm, sincere, calm, cool and collected energy and presence with the ability to develop relationships.
  • Analytical Skills and Attention to Detail – Reviewing clinical documentation and coding.
  • Effectively Communicates – Speaks clearly, listens effectively, and responds well to questions; Writes clearly and informatively; Edits work for errors; Varies writing style to meet needs; Able to read and interpret information; Documents are accurate and delivered on time; Uses good judgement when communicating information.

  • Interpersonal Skills - Builds strong relationships; Flexible and open minded; Receptive to feedback; Motivates employees and peers for the purpose of achieving organizational goals.
  • Professionalism – Approaches others in a tactful manner; Reacts well under pressure; Treats others with respect and consideration regardless of their status or position; Accepts responsibility for own actions; Follows through on commitments.
  • Adaptability – Adapts to changes in the work environment; Adjusts methods to best fit the situation; Able to deal with change, delays, or unexpected events.

    Can work with diverse groups of customers and internal stakeholders.
  • Cultural Sensitivity – Models behaviors that reflect the culture of Reveleer; Awareness of the similarities and differences that exist between employees, teams, departments, and customers to build more effective relationships.
  • Computer Skills – Essential to be skilled in with all Microsoft Suite products (, Excel, Word, PowerPoint, etc.)
  • Job Requirements:

  • Must have a professional coding certificate through AHIMA/AAPC (CRC Certification preferred).
  • Minimum of 5 years coding experience with specific knowledge of Medicare and Commercial Risk Adjustment such as Hierarchical Condition category (HCC)
  • Strong computer skills and high-speed internet access at home
  • Commitment to confidentiality of patient health information
  • Professional, articulate and able to work independently
  • Compensation: $ / hour

    Our compensation reflects the cost of labor across several US geographic markets.

    Pay is based on several factors including market location and may vary depending on job-related knowledge, skills, and experience.

    Reveleer E-Verifies all new hires.

    Reveleer is an equal opportunity employer.

    We do not discriminate on the basis of race, religion, color, national origin, gender, gender identity, sexual orientation, age, marital status, veteran status, disability status or genetic information, in compliance with applicable federal, state and local law.

    Required Skill Profession

    Air Transportation Workers


    • Job Details

    Related Jobs

    Hologic hiring Clinical QA Specialist Job in Newark, DE, United States
    Hologic
    Newark, DE, United States
    Actalent hiring Clinical QA Specialist Job in Durham, NC, United States
    Actalent
    Durham, NC, United States
    Actalent hiring Clinical QA Specialist Job in Chapel Hill, NC, United States
    Actalent
    Chapel Hill, NC, United States
    Actalent hiring Clinical QA Specialist Job in Raleigh, NC, United States
    Actalent
    Raleigh, NC, United States
    Piper Companies hiring QA Clinical Supplies Specialist Job in West Point, Pennsylvania, United States
    Piper Companies
    West Point, Pennsylvania, United States
    Confidential hiring Sr. QA Specialist, Operations Job in Chelsea, Massachusetts, United States
    Confidential
    Chelsea, Massachusetts, United States
    Bristol Myers Squibb hiring Sr. Specialist, QA Operations Job in Indianapolis, IN, United States
    Bristol Myers Squibb
    Indianapolis, IN, United States
    Bristol Myers Squibb hiring Sr. Specialist, QA Operations Job in Indianapolis, IN, United States
    Bristol Myers Squibb
    Indianapolis, IN, United States
    Catalent Pharma Solutions hiring Sr. QA Specialist, Operations Job in Chelsea, MA, United States
    Catalent Pharma Solutions
    Chelsea, MA, United States
    Exact Sciences hiring Sr. Clinical Laboratory QA Specialist Job in Madison, Wisconsin, United States
    Exact Sciences
    Madison, Wisconsin, United States
    Actalent hiring Clinical QA Manager/ Sr. Clinical QA Manager Job in Raleigh, NC, United States
    Actalent
    Raleigh, NC, United States
    Actalent hiring Clinical QA Manager/ Sr. Clinical QA Manager Job in Chapel Hill, NC, United States
    Actalent
    Chapel Hill, NC, United States
    Actalent hiring Clinical QA Manager/ Sr. Clinical QA Manager Job in Durham, NC, United States
    Actalent
    Durham, NC, United States
    Apex Systems hiring QA Specialist Job in Pennsville Township, New Jersey, United States
    Apex Systems
    Pennsville Township, New Jersey, United States
    Pantar Solutions inc hiring QA Specialist Job in Morrisville, North Carolina, United States
    Pantar Solutions inc
    Morrisville, North Carolina, United States
    Insight Global hiring QA Specialist Job in Andover, MA, United States
    Insight Global
    Andover, MA, United States
    Sharp Electronics Corporation hiring QA Specialist Job in Montvale, NJ, United States
    Sharp Electronics Corporation
    Montvale, NJ, United States
    Actalent hiring QA Specialist Job in Fruitland Park, FL, United States
    Actalent
    Fruitland Park, FL, United States
    Actalent hiring QA Specialist Job in St Francis, WI, United States
    Actalent
    St Francis, WI, United States
    Actalent hiring QA Specialist Job in St Francis, WI, United States
    Actalent
    St Francis, WI, United States
    Actalent hiring QA Specialist Job in St Francis, WI, United States
    Actalent
    St Francis, WI, United States
    Mentor Technical Group hiring Specialist QA Job in Juncos, PR, United States
    Mentor Technical Group
    Juncos, PR, United States
    Aston Carter hiring QA Specialist Job in GLENDALE, CA, United States
    Aston Carter
    GLENDALE, CA, United States
    Confidential hiring QA Operations Manager Job in Albany, Georgia, United States
    Confidential
    Albany, Georgia, United States
    MBC Talent Connections hiring QA Operations Manager Job in Albany, Georgia, United States
    MBC Talent Connections
    Albany, Georgia, United States
    Navy Federal Credit Union hiring Business Operations Specialist II (QA Testing) Job in Pensacola, FL, United States
    Navy Federal Credit Union
    Pensacola, FL, United States
    Navy Federal Credit Union hiring Business Operations Specialist II (QA Testing) Job in Winchester, VA, United States
    Navy Federal Credit Union
    Winchester, VA, United States
    Navy Federal Credit Union hiring Business Operations Specialist II (QA Testing) Job in Vienna, VA, United States
    Navy Federal Credit Union
    Vienna, VA, United States
    Insight Global hiring Sr QA Specialist - Supplier QA Job in South San Francisco, CA, United States
    Insight Global
    South San Francisco, CA, United States
    Evotec hiring QA Specialist, Operations - Site Based Seattle, WA Job in Seattle, Washington, United States
    Evotec
    Seattle, Washington, United States
    Sunrise Systems hiring Hiring: Field Specialist QA Operations || Devens, MA Job in Devens, Massachusetts, United States
    Sunrise Systems
    Devens, Massachusetts, United States
    Foundation Medicine hiring Senior Clinical QA Lead Job in Boston, Massachusetts, United States
    Foundation Medicine
    Boston, Massachusetts, United States

    Unlock Your Clinical Operations Potential: Insight & Career Growth Guide


    Real-time Clinical Operations Jobs Trends (Graphical Representation)

    Explore profound insights with Expertini's real-time, in-depth analysis, showcased through the graph here. Uncover the dynamic job market trends for Clinical Operations in remote, us, United States, highlighting market share and opportunities for professionals in Clinical Operations roles.

    78557 Jobs in United States
    78557
    222 Jobs in Remote, Us
    222
    Download Clinical Operations Jobs Trends in Remote, Us and United States

    Are You Looking for Clinical Operations QA Specialist Job?

    Great news! is currently hiring and seeking a Clinical Operations QA Specialist to join their team. Feel free to download the job details.

    Wait no longer! Are you also interested in exploring similar jobs? Search now: .

    The Work Culture

    An organization's rules and standards set how people should be treated in the office and how different situations should be handled. The work culture at Reveleer adheres to the cultural norms as outlined by Expertini.

    The fundamental ethical values are:

    1. Independence

    2. Loyalty

    3. Impartiapty

    4. Integrity

    5. Accountabipty

    6. Respect for human rights

    7. Obeying United States laws and regulations

    What Is the Average Salary Range for Clinical Operations QA Specialist Positions?

    The average salary range for a varies, but the pay scale is rated "Standard" in remote us. Salary levels may vary depending on your industry, experience, and skills. It's essential to research and negotiate effectively. We advise reading the full job specification before proceeding with the application to understand the salary package.

    What Are the Key Qualifications for Clinical Operations QA Specialist?

    Key qualifications for Clinical Operations QA Specialist typically include Air Transportation Workers and a list of qualifications and expertise as mentioned in the job specification. The generic skills are mostly outlined by the . Be sure to check the specific job listing for detailed requirements and qualifications.

    How Can I Improve My Chances of Getting Hired for Clinical Operations QA Specialist?

    To improve your chances of getting hired for Clinical Operations QA Specialist, consider enhancing your skills. Check your CV/Résumé Score with our free Tool. We have an in-built Resume Scoring tool that gives you the matching score for each job based on your CV/Résumé once it is uploaded. This can help you align your CV/Résumé according to the job requirements and enhance your skills if needed.

    Interview Tips for Clinical Operations QA Specialist Job Success

    Reveleer interview tips for Clinical Operations QA Specialist

    Here are some tips to help you prepare for and ace your Clinical Operations QA Specialist job interview:

    Before the Interview:

    Research: Learn about the Reveleer's mission, values, products, and the specific job requirements and get further information about

    Other Openings

    Practice: Prepare answers to common interview questions and rehearse using the STAR method (Situation, Task, Action, Result) to showcase your skills and experiences.

    Dress Professionally: Choose attire appropriate for the company culture.

    Prepare Questions: Show your interest by having thoughtful questions for the interviewer.

    Plan Your Commute: Allow ample time to arrive on time and avoid feeling rushed.

    During the Interview:

    Be Punctual: Arrive on time to demonstrate professionalism and respect.

    Make a Great First Impression: Greet the interviewer with a handshake, smile, and eye contact.

    Confidence and Enthusiasm: Project a positive attitude and show your genuine interest in the opportunity.

    Answer Thoughtfully: Listen carefully, take a moment to formulate clear and concise responses. Highlight relevant skills and experiences using the STAR method.

    Ask Prepared Questions: Demonstrate curiosity and engagement with the role and company.

    Follow Up: Send a thank-you email to the interviewer within 24 hours.

    Additional Tips:

    Be Yourself: Let your personality shine through while maintaining professionalism.

    Be Honest: Don't exaggerate your skills or experience.

    Be Positive: Focus on your strengths and accomplishments.

    Body Language: Maintain good posture, avoid fidgeting, and make eye contact.

    Turn Off Phone: Avoid distractions during the interview.

    Final Thought:

    To prepare for your Clinical Operations QA Specialist interview at Reveleer, research the company, understand the job requirements, and practice common interview questions.

    Highlight your leadership skills, achievements, and strategic thinking abilities. Be prepared to discuss your experience with HR, including your approach to meeting targets as a team player. Additionally, review the Reveleer's products or services and be prepared to discuss how you can contribute to their success.

    By following these tips, you can increase your chances of making a positive impression and landing the job!

    How to Set Up Job Alerts for Clinical Operations QA Specialist Positions

    Setting up job alerts for Clinical Operations QA Specialist is easy with United States Jobs Expertini. Simply visit our job alerts page here, enter your preferred job title and location, and choose how often you want to receive notifications. You'll get the latest job openings sent directly to your email for FREE!