Careers

HQSI CareersCurrent Employment Opportunities

As a leader in healthcare quality improvement, we know our employees are crucial to our success, and we are committed to attracting and retaining dedicated, talented, and performance-driven professionals. We offer a dynamic, team-oriented work environment, competitive salaries and an excellent benefits program.

HQSI is an equal opportunity/affirmative action employer. It is the policy of HQSI to provide equal opportunity for all qualified persons and to not discriminate against any applicant for employment because of race, color, religion, national origin, sex, age, disability, veteran status, or any other status protected by state or local law.

Open Positions

Remote Nurse/Allied Health Professional Reviewer

Online Application

 

Summary

HQSI is recruiting experienced remote medical review auditors to conduct utilization review (UR) of appeals using electronic medical records on a per case basis. The Medical Review Auditor performs the required work from a home office on their own schedule as long as established timelines are met. Work is performed through secure internet/cloud based portal. The ideal candidate should have 1-3 years UR experience and be a licensed RN, LPN or other credentialed/licensed allied healthcare professional. Experience in reviewing and/or coding clinical appeals is a PLUS. HQSI will provide a minimum of five cases to review per week, as review volume allows.

 

Remote Medical Review Auditors must have high-speed Internet access, a home computer with a current MS Windows operating system, the current browser version and/or one previous version for Chrome, Firefox, Internet Explorer, or Safari, and Adobe 9.0 or better

 

Key Responsibilities:

  • For each appeal, screen medical cases and write an accurate, clear and concise summary for review by physician reviewer.
  • Reason for admission
  • Reason for presentation
  • Signs, symptoms, and physical exam
  • Laboratory and Radiology results
  • Physician Orders

 

Knowledge, Experience, Skills

 

Knowledge of:

  • Medical terminology
  • Evidence-based medical criteria and software programs
  • Medical record review and clinical data summarization
  • Current standards of medical practice
  • Performing work in a virtual environment

 

Experience in:

  • Medical record review and clinical abstraction
  • Application of screening criteria
  • Writing accurate, timely, and succinct correspondence
  • Complying with HIPAA/HITECH laws and regulations
  • Multitasking while meeting deadlines

 

Skills and requirements include:

  • Reliability and commitment to meeting tight deadlines (24-48 hour turnaround time on many assigned cases)
  • Computer proficiency (including MS Windows, MS Office, and the Internet)
  • Commitment to privacy, security and confidentiality of all medical chart documentation
  • Personal discipline to work remotely without direct supervision – Self starter
  • Exemplary professionalism and attention to detail and completeness
  • Strong organization skills; interpersonal and customer service skills; written and oral communication skills; and problem solving skills
  • Able and willing to be responsive to fluctuating case loads
  • Professional and timely response expected to all telephone, Email and secure Email inquiries

 

Educational background:

  • RN, LPN or other allied healthcare professional with relevant certifications and/or licensure

 

EEO/AAE