Job Description
Medical Quality Reviewer
Quality audit findings from this position will contribute to the support and training of physicians on proper coding and medical record documentation practices to support improvement in quality metrics. As a result, this role will be required to conduct regular internal provider audits and then document, summarize and report findings. Additionally, participation in the annual HEDIS and QARR hybrid medical record review project will be required. This role may also participate in member outreach and education as needed to ensure members receive appropriate services.
Scope of Role & Responsibilities
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