Quality Assurance Specialist

Preventive Measures•Washington, DC

41d

About The Position

The Quality Assurance (QA) Specialist is responsible for vetting and ensuring the accuracy, completeness, and compliance of the client charts within the program. This role focuses on vetting authorization charts, monitoring documentation timelines, and ensuring adherence to payer, regulatory, and organizational standards. The QA Specialist collaborates closely with Clinical Managers to ensure accuracy of charts, communicate upcoming client deadlines regarding treatment plans, assessments, authorization expiration dates and other related client information.

Requirements

Must have excellent verbal and written communication skills, active listening skills and exceptional customer service skills to evaluate clients, assess their care needs and guide through the admissions process
Proficient with data entry and other technical computer skills requiring information to be entered into digital systems, accessing digital forms, and creating electronic patient files
Must have excellent time management skills to schedule appointments for patients and manage multiple patients at once
Commitment to ethical practice and adherence to all professional and legal confidentiality guidelines
High School Diploma Required, Bachelor’s degree preferred
2+ years experience in behavioral health
Experience using Electronic Health Records (EHR) systems.
Experience using Microsoft Suite (Excel, Word, Powerpoint)

Responsibilities

Review and vet client charts for completeness, accuracy, and program/regulatory compliance.
Confirm Consumer Choice Forms and required consents are completed and up-to-date.
Monitor for expired or expiring treatment plans and authorizations.
Track and follow up on Diagnostic Assessment (DA) updates
Monitor DLA-20 completion and required updates
Monitor CAFAS updates for child/adolescent clients (when applicable)
Proactively communicate deficiencies, expiring documentation, and corrective actions to Clinical Managers, Care Coordinators, and administrative staff.
Maintain and update tracking system.
Collaborate and Communicate with Community Support Workers.
Support internal audits and prepare documentation for external reviews
Participate in scheduled meetings, including staff meetings and clinical meetings
Participate in trainings to maintain and enhance job skills
Participate in internal quality improvement initiatives.
Perform other responsibilities within reason as needed.