BH21 - Quality Assurance Analyst and Compliance Specialist - Full Time - 40 Hours/Week (BH21)

Episcopal Community Services (ECS) • San Francisco, CA

28d • $33 - $35 • Onsite

About The Position

The Behavioral Health Department provides mobile and embedded individual and group behavioral health services to homeless, or formerly homeless program participants struggling with mental health and/or substance abuse needs. The ECS Behavioral Health clinicians provide intensive and consistent services that “follow” clients across shelter, interim housing, and permanent housing locations. SUMMARY OF DUTIES AND RESPONSIBILITIES Handles general office and clinic activities as it is related to billing, compliance and quality assurance to support the care staff and leadership/management. Ensures the timeliness, quality and accuracy of billing documentation and files according to established programmatic, county, state and federal guidelines. Ensures all documents and records are in compliance with Medi-Cal billing standards and HIPAA confidentiality standards as per county, state and federal contract requirements. Verifies the presence of all required clinical documentation and maintains the proper submission and storage of physical and electronic client records, including those of discharged or expired cases. Troubleshoots billing issues, inaccuracies and claims denials. Submits billing summaries and reports necessary for invoicing to appropriate department(s) and funders. Prepares charts, documentation and records for technical and clinical audits, such as the county or state audits, and professional certifications. Assists with managing required onboarding tasks for new staff. i.e. credentialing and training of appropriate professional standards and practices. Tracks staff completion of mandated training and certifications and provides reminders and escalation as needed. Supervises and audits staff entries for internal records, and correspondence for timely and accurate documentation, data collection, care coordination etc. Assists with productivity tracking, client and staff outcomes and satisfaction ratings etc. to monitor and optimize team performance and efficiency. Creates a more streamlined and organized administrative system by devising electronic solutions for the administration binder. Manages, compiles and organizes essential documentation for the BOCC Acts as the Epic (EHR) expert for the Clinical Manager, Front Desk personnel, and Template Builder roles within the system to enhance operational proficiency. Participates actively in all on-going Epic training sessions as a Champion to offer expertise and guidance to staff and leadership/management. Attends scheduled meetings on behalf of the supervisor while taking notes. Maintains policies and procedures that comply with relevant regulatory standards, accreditation requirements, and best practices. Conducts regular and on-going screenings and background checks of clinical staff according to the Behavioral Health’s departmental policy. Monitors regulatory changes and updates related to departmental services to implement quality improvement initiatives, service delivery enhancements, and organizational effectiveness. Identifies potential risks and liabilities within the organization’s operations and develop strategies to mitigate risks and ensure client safety and confidentiality.

Requirements

• High School diploma or equivalent
• Microsoft Excel expertise, including making graphs and charts from data analytics and advanced use of spreadsheet formulas.
• Proficient in the use of PC computers and associated software.
• At least three years of experience working in an office environment.
• Experience and success in office management.
• Ability to prepare written reports and correspondence.
• Ability to understand and follow verbal and written instructions.
• Ability to effectively communicate, verbally and in writing.
• Must be able to maintain a high level of confidentiality.
• Must have excellent organization and time management skills.
• Ability to build and maintain positive internal and external relationships.
• Ability to provide exemplary customer service to all employees and outside constituents.
• Functions independently and as a team member in a multi-task environment.
• Must be flexible and able to handle multiple priorities.
• Ability to adjust to high pressure and rapidly changing business conditions.
• Have experience using electronic health records and databases.
• Demonstrate behavior that supports the organization’s mission, vision, and values.
• Adhere to all program, funder, and organizational policies, and procedures.
• Communicate effectively and model integrity, fairness, and ethical business practices.

Responsibilities

• Handles general office and clinic activities as it is related to billing, compliance and quality assurance to support the care staff and leadership/management.
• Ensures the timeliness, quality and accuracy of billing documentation and files according to established programmatic, county, state and federal guidelines.
• Ensures all documents and records are in compliance with Medi-Cal billing standards and HIPAA confidentiality standards as per county, state and federal contract requirements.
• Verifies the presence of all required clinical documentation and maintains the proper submission and storage of physical and electronic client records, including those of discharged or expired cases.
• Troubleshoots billing issues, inaccuracies and claims denials.
• Submits billing summaries and reports necessary for invoicing to appropriate department(s) and funders.
• Prepares charts, documentation and records for technical and clinical audits, such as the county or state audits, and professional certifications.
• Assists with managing required onboarding tasks for new staff. i.e. credentialing and training of appropriate professional standards and practices.
• Tracks staff completion of mandated training and certifications and provides reminders and escalation as needed.
• Supervises and audits staff entries for internal records, and correspondence for timely and accurate documentation, data collection, care coordination etc.
• Assists with productivity tracking, client and staff outcomes and satisfaction ratings etc. to monitor and optimize team performance and efficiency.
• Creates a more streamlined and organized administrative system by devising electronic solutions for the administration binder.
• Manages, compiles and organizes essential documentation for the BOCC Acts as the Epic (EHR) expert for the Clinical Manager, Front Desk personnel, and Template Builder roles within the system to enhance operational proficiency.
• Participates actively in all on-going Epic training sessions as a Champion to offer expertise and guidance to staff and leadership/management.
• Attends scheduled meetings on behalf of the supervisor while taking notes.
• Maintains policies and procedures that comply with relevant regulatory standards, accreditation requirements, and best practices.
• Conducts regular and on-going screenings and background checks of clinical staff according to the Behavioral Health’s departmental policy.
• Monitors regulatory changes and updates related to departmental services to implement quality improvement initiatives, service delivery enhancements, and organizational effectiveness.
• Identifies potential risks and liabilities within the organization’s operations and develop strategies to mitigate risks and ensure client safety and confidentiality.

Benefits

• ECS offers industry leading healthcare benefits to support your physical and mental well-being.
• ECS will consider for employment qualified applicants with arrest and conviction records as consistent with San Francisco's Fair Chance Ordinance.
• ECS values a workplace where every individual is respected, supported, and given equal opportunity to thrive. We are an equal opportunity employer dedicated to creating a welcoming and inclusive environment for all.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED