Quality Control Specialist - Health Home

Urban Health Plan • Bronx, NY

1d • Hybrid

About The Position

Our Health Home Department at Urban Health Plan is not a physical place, nor a residence, nor a 'Home Health' program. Instead, it is a specialized service provided to patients that are enrolled in Medicaid who have two or more chronic health conditions (e.g. Asthma, Diabetes) or other qualifying conditions that include HIV/AIDS, or SMI. As a member of the Health Home Division- the Quality Control Specialist (QCS) is responsible for processing health home billing and Quality Assurance standards within the team, ensures compliance with all regulatory and documentation standards and conducts routine audits to maintain data integrity, identify discrepancies, and support accurate, timely billing. This position is considered intermittent hybrid, meaning the primary duties are remote and also require a minimum of 2-4 monthly onsite days within our Bronx offices.

Requirements

• HS Diploma required (Advanced education or certifications in billing, excel, or health information management is a plus)
• 1-2 years of previous experience with billing, reporting, medical records, tracking.
• Advanced level of proficiency with Microsoft Office, including Microsoft Excel.
• Bilingual English/Spanish is required.
• Commitment to excellence and INTEGRITY!

Nice To Haves

• Advanced education or certifications in billing, excel, or health information management is a plus

Responsibilities

• Review Health Home billing and resolve errors or discrepancies.
• Performs quality assurance checks on documentation, Health Home documents and services.
• Maintain and update excel trackers for program data and performance metrics.
• Develop reports using data to track trends, performance and gaps.
• Conducts quarterly chart audits to ensure accuracy in documentation and services.
• Assists with QA initiatives
• Engages in a variety of administrative support activities including data entry, filing, scanning, and other duties as assigned by the supervisor.

Benefits

• Fully funded Health Insurance for yourself
• 73.5% funded Health Insurance for your family
• Dental Insurance
• $50,000 term life Insurance
• 401(k) Retirement Savings (including annual UHP Contribution)
• Comprehensive time off including paid vacation, personal time, sick time, and paid holidays (including your birthday!)

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 251-500 employees