Administrative Coordinator-Clinical Quality Administration

About this role

American Specialty Health Incorporated (ASH) is seeking an Administrative Coordinator to join our Clinical Quality Administration department.

The primary purpose of this position is to provide administrative and operational support for Clinical Quality Administration (CQA) activities, including committee support, credentialing processes, appeals, corrective action plans, investigations, and practitioner communications. Perform assigned duties with accuracy, timeliness, and attention to confidentiality, in accordance with established policies, procedures, and accreditation requirements.
Hourly Salary Range
American Specialty Health complies with state and federal wage and hour laws and compensation depends upon candidate’s qualifications, education, skill set, years of experience, and internal equity. $17.84 to $20.00 Hourly Wage Range.
Remote Worker Guidelines

• Remote Worker Guidelines: This position will be trained remotely and must be able to work from home (WFH) in a designated work area with company-provided technology equipment. This WFH position requires you have a stable connection to your Internet Service Provider with the ability to participate by video in online meetings over a reliable and consistent network. The internet connection must have a consistent 50 down/10 up Mbps minimum internet speed. 100 down/20 up is recommended to support higher quality video meetings.
Responsibilities

• Assists with assigned CQA activities within the defined scope, under the supervision of Coordinators and Program Managers.

• Supports accurate, timely completion of projects and tasks in accordance with departmental procedures and timelines.

• Works cooperatively with internal teams and external contacts to support CQA operations.

• Maintains strict confidentiality of documentation, clinical records, and committee materials in accordance with ASH policies.

• Supports department efficiency through appropriate use of system based technology and tracking tools.

• Provides back up administrative support to other CQA staff as needed.

Clinical Committee Support - Provides administrative support for clinical committees as directed.

• Assists with preparation of PRC and QIC meetings.

• Document preparation and distribution.

• Agendas, attendee lists, and meeting materials.

• Supports scheduling activities by assisting with outreach to committee members, chairs, consultants, and internal staff to support quorum and attendance.

• Assists with recording, transcribing, and formatting contemporaneous meeting minutes.

• Supports maintenance of PRC and QIC action logs and assists with routing materials according to policy.

• Ensures documents are prepared, handled, and distributed in accordance with confidentiality and peer review protections.

• Coordinates with internal departments as directed regarding committee related processes.

• Assists with committee related projects, reports, research, follow up tasks, and correspondence as requested.

• Assists with data compilation and basic analysis for committee reporting and tracking purposes.

Credentialing and Appeal Support - Assists with preparation and processing of:

• Credentialing committee decisions.

• Tier appeals and summaries for QIC review.

• Acknowledgment letters, decision letters, and related correspondence.

• Supports timely uploading, filing, and tracking of committee and appeal decisions in designated systems.

• Assists with preparation of termination appeal documentation for committee review.

• Provides administrative support for credentialing issue file summaries presented to PRC.

• Maintains logs and tracking tools related to appeals and credentialing actions.

Corrective Action Plan (CAP) Administrative Support

• Assists with the generation and distribution of CAP correspondence as directed.

• Logs and files CAP related data in appropriate systems.

• Assists with follow up tracking of CAP responses and preparation of files for committee review when needed.

• Copies, files, and maintains CAP documentation according to policy.

• Assists with preparation of CAP related reports and summaries as requested.

Clinical Services Investigation Team (CSIT) Administrative Support

• Assists with logging and distribution of CSIT inquiry and education letters.

• Provides administrative and data gathering support for CSIT investigations.

• Assists with medical record and x ray requests, tracking receipt and forwarding materials to designated clinicians or CQEs.

• Supports document preparation for committee review, including copying and blinding.

• Assists with logging calls, correspondence, and investigation activities.

• Supports preparation of CSIT reports as directed.

Termination, Appeals, and Hearing Process Support - Assists with administrative coordination of:

• Notices of Termination.

• Appeal acknowledgments and determinations.

• Practitioner hearing documentation.

• Supports preparation of appeal summaries and supporting materials for QIC review.

• Logs, files, and tracks termination, appeal, hearing, and NPDB related documentation as directed.

• Assists with scheduling logistics and record maintenance related to practitioner hearings.

• Supports preparation of reports related to terminations, appeals, and hearings.

Provider Education and Correspondence Support - Assists with preparation and distribution of practitioner education and inquiry letters as directed, including:

• Medical records education letters related to member grievances.

• Tier with X ray MNR education letter series (credentialing and CPS related).

• Committee recommended education and attestation letters.

• Substandard Documentation Education Letters (114 series).

• Duplication of Clinical Data Education Letters (101 series).

Additional Responsibilities

• Assists with preparation of standardized departmental and individual reports.

• Supports accreditation and delegation activities for Clinical Quality Administration.

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