Process Auditing & Record Review: Conduct routine, structured audits of patient case files, member records, and documentation to verify accuracy, completeness, and compliance with institutional standards.
Data Collection & Entry: Accurately extract, compile, and maintain data from various health information systems to support quality scorecards and performance monitoring.
Regulatory Compliance Support: Assist in gathering documentation and prepping audit trails for scheduled state and federal reviews (CMS, DOH, NCQA HEDIS).
Trend Identification: Help monitor operational workflows and flag inconsistencies, documentation gaps, or deviations from established protocols to senior QA team members.
Reporting & Tracking: Maintain internal tracking logs, compile compliance spreadsheets, and assist in drafting basic data summary reports for quality improvement committees.
Cross-Functional Collaboration: Partner with clinical, customer service, and care management teams to clarify documentation inaccuracies and support corrective action plans.
Education: Bachelor’s degree in Healthcare Administration, Public Health, Health Information Management, Business Administration, or a related field.
Experience: 0–2 years of experience in an administrative, analytical, or auditing role. Experience or internships within a healthcare or health insurance setting are highly preferred.
Core Skills:
Exceptional attention to detail and strong organizational skills.
Intermediate proficiency with Microsoft Office Suite (particularly Excel functions like filtering, sorting, and basic data entry formatting).
Ability to handle highly sensitive, confidential patient information with strict adherence to HIPAA guidelines.
Communication: Strong written and verbal communication skills; comfortable reaching out to internal teams to gather or clarify data.
Familiarity with healthcare quality improvement frameworks (e.g., PDSA cycles, Lean concepts).
Basic understanding of Medicaid/Medicare plan structures, HEDIS metrics, or clinical documentation standards.
Comfort learning new electronic health records (EHR) and database management software.
Skills Required
- Bachelor's degree in Healthcare Administration, Public Health, Health Information Management, Business Administration, or related field
- 0-2 years experience in an administrative, analytical, or auditing role
- Experience or internships within a healthcare or health insurance setting
- Exceptional attention to detail and strong organizational skills
- Intermediate proficiency with Microsoft Office Suite, particularly Excel (filtering, sorting, basic data formatting)
- Ability to handle sensitive, confidential patient information with strict adherence to HIPAA
- Strong written and verbal communication skills
- Familiarity with healthcare quality improvement frameworks (PDSA, Lean concepts)
- Basic understanding of Medicaid/Medicare plan structures, HEDIS metrics, or clinical documentation standards
- Comfort learning new electronic health records (EHR) and database management software
What We Do
Zealogics LLC provides a broad range of IT consulting, systems implementation and application outsourcing services through an optimized global delivery model. Zealogics builds deep knowledge of traditional product engineering across mechanical, electronics and software platforms, to enable clients to navigate their digital transformation. Zealogics values engineering techniques, automation frameworks, and reference models which are refined through engagements with Fortune 500 enterprises and OEMs. We combine customer-centric product strategies through a collaborative approach for execution. We help to harmonize processes, identify bottlenecks, and eliminate non-value tasks to deliver world-class products. With impeccable focus on client needs we connect specialized resources for the right positions, both for full time and contractual placements. Our long-term relationships with employees and clients have been built in an environment of integrity and commitment, with a shared goal of mutual success. Zealogics hires experienced people to solve a wide array of IT and Engineering challenges that our clients face. Our guarantee - Zealogics provides the best value services in town.
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