Job Details

Quality Improvement Medical Records Specialist

Position Number: 6451439
Location: Pomona, CA
Position Type: Health - Healthcare Administration

Quality Improvement Medical Records Specialist

Posting Number: S01648
Campus:
Department: 1313-Patient Care Center - PCC

Classification Pay Scale
In compliance with SB 1162, Western University of Health Sciences is providing a pay scale for this position. The pay scale reflects the minimum and maximum target for new hire salaries for this position. Within this range, the individual pay is determined by a variety of factors, including but not limited to job-related skills, experience, relevant education or training, and work location. Please note that the compensation details listed reflects the base salary only.

Expected Pay Scale
Minimum: $23.00 Hourly
Maximum $26.50 Hourly

Job Summary

To provide support services for medical records for WesternU Health. Appropriately and accurately verify and process requests for charts to be pulled for patient care, quality review, and audits in a timely manner. Release information to patients, healthcare facilities and
other entities with following all laws and regulations including HIPAA. In addition, supports the Quality Improvement team with HEDIS, Stars, P4P and Risk Adjustment activity functions related to outreach, collection and accurate data entering of medical records and service data, according to NCQA HEDIS/STARS and CMS Medicare Advantage guidelines.

The Quality Improvement Medical Record Specialist coordinates internal/external data reports aimed in closing quality care gaps and supports internal staff with daily Quality Improvement tasks such as Gap/Care due list, filing, faxing, copying, and scanning of files, acts as a liaison for the department in routine administrative and project coordination activities, including conduct effective research to meet project goals and assigned task and attends to Health Plans, IPA/MSO, provider, and inter-departmental meetings.

Knowledge, Skills and Abilities

Individuals must possess the knowledge, as well as the following skills and abilities or be able to perform the essential functions of the job, with or without reasonable accommodation using some other combination of skills and abilities.

Strong customer focus, interpersonal, collaboration, written/verbal communication, prioritization and computer skills.
Must be able to establish daily work priorities and work efficiently to contribute to the successful overall maintenance of the credentialing process.
Able to handle multiple simultaneous tasks and complete work projects in designed time frames.
Demonstrated attention to detail and good organizational capability.
Strong working knowledge of medical terminology including insurance credentialing.
Experience working with Windows based applications: Excel, Word, and Outlook.
Significant knowledge of State and Federal Regulatory requirements and accreditation standards, e.g., HIPAA, NCQA, NPDB, Title XXII, CAQH and NPPES.
Considerable working knowledge of practice management applications.
Ability to type, use a ten-key by touch, telephone, fax copier, scanning.

Required Qualifications

Education: Any combination, training or experience that provides the required knowledge, skills and abilities.
Experience: Two years of relevant experience in an outpatient clinic setting, with a focus on processing medical records requests and the ability to extract pertinent data from medical records.

Preferred Qualifications

Preference will be given to candidates holding certification in the appropriate professional field and organizations.

Education: Associate degree is preferred.
Experience: Background in a clinical academic setting is highly preferred.

Posting Date: 08/07/2025
Closing Date:

Essential Job Duties

To apply, visit https://jobs.westernu.edu/postings/33729