Performs medical record review and data collection for quality and reimbursement purposes, process improvement and compliance. Assists or engages in activities related to the improvement or maintenance of Organization’s Health Plan Star Rating. Formal Education Required: a. Graduate of an accredited school of professional nursing or a school accepted for candidacy status from an accrediting body.b. BSN preferred.c. Current RN licensed in the State of Ohio in good standing. Experience & Training ... more details
RN Coding Auditor - Records Review
SummaCare - 1200 E Market St, Akron, OH
Part-Time / 20 Hours / Days
Remote
SummaCare is a Summa Health entity that offers health insurance in northern Ohio. As a regional, provider-owned health plan, SummaCare is based in Akron, Ohio, and provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2024 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits.
Summary:
Performs medical record review and data collection for quality and reimbursement purposes, process improvement and compliance. Assists or engages in activities related to the improvement or maintenance of Organization’s Health Plan Star Rating
Formal Education Required:
a. Graduate of an accredited school of professional nursing or a school accepted for candidacy status from an accrediting body.
b. BSN preferred.
c. Current RN licensed in the State of Ohio in good standing.
Experience & Training Required:
a. Five (5) years performing same or similar responsibilities. Relevant experience includes clinical nursing experience, medical record review or clinical data entry.
Other Skills, Competencies and Qualifications:
a. Familiarity with multiple Electronic Medical Records.
b. Skilled in the use of Microsoft Office Suite.
c. Demonstrated analytical and problem solving skills.
d. Ability to effectively communicate and interact, both written and verbal.
e. Maintains skill levels needed to utilize multiple software programs on laptop computers and scanners.
f. Ability to work autonomously and in a team environment.
g. Organize and manage time to accurately complete tasks within designated time frames in fast-paced environment.
h. Maintain current knowledge of and comply with regulatory and company policies & procedures.
i. Maintain confidentiality of patient and business information.
j. Flexible: Able to adjust work hours to meet business demands.
k. Ability to travel from location to location
Level of Physical Demands:
a. Sit for prolonged periods of time.
b. Bend, stoop, and stretch. Able to crawl under desks to plug in power cords.
c. Lift up to 20 pounds.
d. Manual dexterity to operate computer, phone, and standard office machines.
$34.74/hr - $41.69/hr
The salary range on this job posting/advertising is base salary exclusive of any bonuses or differentials. Many factors, such as years of relevant experience and geographical location are considered when determining the starting rate of pay. We believe in the importance of pay equity and consider internal equity of our current team members when determining offers. Please keep in mind that the range that is listed is the full base salary range. Hiring at the maximum of the range would not be typical.