LPN Auditor

Banner Health

. Independently triage incoming referrals, manage case assignments, and oversee cases through resolution .

Posted 10/30/2026part-timeRemote • Arizona • United StatesJuniorMid-Level💰 $28 - $47 per hourWebsite

Core Competencies

Role fit

Core Competencies

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Demonstrates expertise in medical record auditing, data analysis, and compliance with HEDIS and AHCCCS standards. Proficient in developing audit tools and processes while effectively communicating findings and recommendations to healthcare providers.

Highest-signal resume keywords

Current Unrestricted State Of Arizona LPN LicenseHEDIS Specifications KnowledgeData Analysis Using Microsoft ExcelMedical Record AuditingStrong Leadership And Problem-Solving Skills

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills

Medical Record AbstractionData Collection InstrumentsQuality Medical Record ReviewsCorrective Action PlansData Evaluation And Reporting

Soft Skills

Excellent Verbal And Written Communication SkillsAttention To Detail And AccuracyStrong Collaborative SkillsAbility To Work IndependentlyAbility To Prioritize Workload

Tools & Technologies

ManagedCare.comTCSSurvey ToolsDatabases For Quality Studies

Certifications & Qualifications

Current Unrestricted State Of Arizona LPN License

Industry Keywords

AHCCCSNCQACMS StandardsQuality Of Care ConcernsInterdisciplinary Team Collaboration

About the role

Key responsibilities & impact

Independently triage incoming referrals, manage case assignments, and oversee cases through resolution
Coordinate and perform quality medical record reviews for PCPs, OBGYNs, and High Volume Specialists
Assist the QM RN with investigation and research of quality-of-care concerns
Abstract medical records, analyze data, and import data to satisfy contract requirements and organizational initiatives
Develop clinical medical record audit tools and processes
Conduct data analysis using Microsoft Excel and data from ManagedCare.com, TCS, medical records, and survey tools
Retrieve and perform medical record audits to determine provider compliance with AHCCCS documentation standards
Monitor and track Corrective Action Plans and communicate audit results and best-practice recommendations to providers
Provide written documentation and Corrective Action Plans and coordinate with the Credentialing Department
Report potential risk or compliance issues and assist with QM policies and procedures
Aggregate and analyze annual medical record audit results for OFR-required data
Prepare monthly provider profile data reports for the Credentialing Department
Abstract and assist with analysis of medical-record data according to HEDIS specifications
Collaborate with the HEDIS team on performance measures, methodology, and processes
Create datasets and databases for quality, medical management, and departmental studies
Support continuous improvement and complete assigned AHCCCS review work-plan tasks

Requirements

What you’ll need

Current, unrestricted State of Arizona LPN license
Two years of experience, preferably in a family practice or pediatric medical office setting
Ability to travel to all contracted sites, which may necessitate occasional overnight stays
Ability to work independently and as part of an interdisciplinary team
Excellent verbal and written communication skills
Strong collaborative skills
Attention to detail and accuracy
Knowledge and understanding of HEDIS specifications
Strong leadership, problem-solving, and investigative skills
Ability to maintain strict confidentiality
Ability to prioritize workload in a fast-paced environment
Ability to implement standards, data sources, research tools, and data collection instruments
Ability to collect, analyze, describe, and evaluate data and write reports
Ability to implement and track process-improvement effectiveness
Ability to recognize risk-management concerns
Ability to review and extract significant data from medical records
Knowledge of NCQA, HEDIS, AHCCCS, and CMS standards and reporting requirements

Benefits

Comp & perks

Comprehensive one-on-one training provided by experienced investigators
Remote work opportunity
Note: Banner Staffing Services roles do not offer medical benefits or paid time off accrual
Assignment-based role with no guarantee of hours