Quality Assurances Specialist

Freeman Health System

1d • Onsite

About The Position

The Quality Assurance Specialist (QA Specialist) has knowledge of documentation standards for a variety of payer systems and has knowledge in CPT, and ICD-10CM coding in a Behavioral Health Psychiatric outpatient practice environment. The primary responsibility is focused monitoring and billing reviews to ensure compliance with existing contracts. Results of review will be submitted to the Quality Assurance Team Lead and Quality Assurance Supervisor, with summary results submitted to the Compliance Committee. QA Specialist may assist with making necessary edits or corrections to billing and documentation in the Ozark Center Electronic Medical Record. QA Specialist will have a basic understanding of healthy interaction with individuals impacted by a variety of behavioral health (addiction/substance use and mental health) issues, recognizing that the individuals we serve often times have experienced trauma that affects their development and adjustment. QA Specialist will be trained in trauma-informed care and will work to help create a work environment that is sensitive and responsive which will prevent victimization, abuse, or trauma. The QA Specialist reports to the Quality Assurance Team Lead.

Requirements

• Knowledge of documentation standards for a variety of payer systems.
• Knowledge in CPT and ICD-10CM coding in a Behavioral Health Psychiatric outpatient practice environment.
• Basic understanding of healthy interaction with individuals impacted by a variety of behavioral health (addiction/substance use and mental health) issues.
• Ability to work under stressful conditions.
• Ability to work irregular hours.
• High school diploma or equivalent.
• A minimum of one (1) years experience in clinical/medical office.

Nice To Haves

• Will be trained in trauma-informed care and will work to help create a work environment that is sensitive and responsive which will prevent victimization, abuse, or trauma.

Responsibilities

• Conduct assigned monitoring and audits prior to deadlines and share those results with the Quality Assurance Team Lead and Quality Assurance Supervisor.
• Complete corrections to billing in the Electronic Medical Record using set procedures as assigned.
• Provide education and training for providers and staff regarding documentation requirements and procedures.
• Assist in compilation of the Incompletes Report and communicate with Program Directors, Assistant Directors and providers in its remediation.
• Assist the Quality Assurance Supervisor during audits by external parties/payers.
• Remain up to date on contract documentation requirements.

What This Job Offers

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