Quality Assurance Specialist

First Call Hospice • Citrus Heights, CA

1d

About The Position

So, you like working with a creative, dynamic team and making a difference? Sometimes the grass is greener! The mission of First Call Hospice, a locally owned agency founded in 1993, is to provide individualized quality hospice care to meet the unique needs of patients with a limited life expectancy. The primary goal of First Call Hospice is to enhance the quality of life when the quantity of life is limited. Rated one of Sacramento's 2024 Best Places to Work, First Call Hospice is growing and looking for experienced, compassionate Quality Assurance Specialist to join our team! JOB SUMMARY The Quality Assurance Specialist is responsible for analyzing data integrity and consistency of documentation and assessment processes. This position will ensure appropriate ICD-9 – ICD-10 coding and sequencing and will work with clinical staff to clarify documentation and data integrity issues.

Requirements

• Active California RN or LVN license required
• 1-2 years of experience of hospice clinical, coding, or billing experience required.
• Working knowledge of ICD-9/ICD-10 coding.
• Knowledge of federal regulations and state licensure requirements.
• Working knowledge of computer systems.
• Licensed driver with automobile that is in good working order and insured in accordance with organization requirements.
• Excellent coordination and communication skills.
• Detail oriented and able to work with minimal supervision

Responsibilities

• Prospectively reviews all assessments to ensure appropriateness, completeness, and compliance with federal and state regulations and organization policy.
• Ensures appropriate ICD-9 – ICD-10 coding and sequencing as it relates to the patient’s medical condition, including any co-morbidities.
• Consults with appropriate clinical staff to clarify any data integrity issues and works with clinician to make appropriate corrections per organization policy.
• Reviews visit utilization for appropriateness of care guidelines and patient condition; reports potential financial losses and/or underutilization to the clinical manager/designee.
• Notifies Quality Assurance and Agency Managers of problematic trends as a result of documentation review.
• Participates in Quality Improvement and Corporate Compliance activities as assigned.
• Assists with other chart audit activities as assigned.
• Maintains professional and technical knowledge by attending educational workshops and reviewing professional publications.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed
• Number of Employees: 5,001-10,000 employees