Quality Management Assistant

Centers Home•Staten Island, NY

About The Position

Provides general non-clinical assistance to the QM Director/Compliance Officer and the QM Clinical Analyst. Responsibilities include maintaining spreadsheets, faxing, copying, scanning, and file maintenance. Handles medical record requests, including receiving, logging, obtaining authorizations, and preparing records for QM clinical review. Collaborates with Accounts Receivable to prepare invoices, ensure fee collection, and release records post-payment. Processes Medicare Notices of Non-coverage and Patient Acknowledgement forms, reviewing them for completeness and providing feedback to staff. Conducts compliance and quality-related auditing as assigned, including patient signature audits, visit time auditing, HHA vendor exception auditing, and HHA conflict resolution, compiling reports and providing feedback. Assists with vendor-related activities such as new contract management, vetting, obtaining insurance certificates, wage parity certifications, and updating contact lists. Supports Medicare Expedited appeals by logging requests, obtaining documents, forwarding to the QIO, and tracking status. Assists with tracking and correspondence for lawsuits. Identifies charts for utilization review, assigns reviewers, ensures document availability, and monitors review completion timelines. Assists with logging and tracking incident reports, ensuring their completeness. Supports the preparation of Professional Advisory Committee and Compliance Committee meetings, including setup, invitations, presentations, handouts, and minutes. Performs other related duties in the Quality Management/Compliance Department.

Requirements

At least 2 years’ experience in an administrative assistant’s role
Proficiency in Word, Excel, PowerPoint

Nice To Haves

Previous work in quality management or compliance desirable.
Prior work in CHHA or LHCSA a plus.
College degree preferred.

Responsibilities

Provides general non-clinical assistance to the QM Director/Compliance Officer and the QM Clinical Analyst.
Maintains spreadsheets, faxes, copies, scans, and performs file maintenance.
Receives and logs medical record requests, obtains necessary authorizations for release of PHI, and prints records for QM clinical review.
Works collaboratively with Accounts Receivable to prepare invoices, ensures fees are collected, and records are released after receipt of payment.
Receives Medicare Notices of Non-coverage and Patient Acknowledgement forms from field staff and processes related workflow.
Reviews forms for proper completion and provides feedback to clinician and/or Directors of Nursing/Rehab regarding errors or omissions.
Conducts compliance and quality related auditing as assigned.
Auditing includes patient signature audits, visit time auditing, HHA vendor exception auditing, HHA conflict resolution.
Compiles related reports and provides feedback to staff and vendors as applicable.
Assists the QM Director/Compliance Officer with vendor related activities including new contract management and vetting, obtaining insurance certificates, wage parity certifications and yearly update of vendor personnel contact lists.
Maintains spread sheets and files accordingly.
Assists QM with Medicare Expedited appeals: logs request, obtains necessary documents from staff, forwards to the QIO, prints chart and sends chart to QIO if requested.
Tracks status and response to appeal.
Assists QM Director with tracking and correspondence on lawsuits.
Identifies charts for utilization review under guidance of QM Clinical Analyst.
Assigns charts to reviewers.
Ensures all paper documents are available for review.
Assists QM Dept. to ensure reviews are completed in the time frame allotted and gives reports to Director/Manager.
Assists QM with logging and tracking receipt of written incident report from the clinical staff.
Works with QM to ensure reports are reviewed and complete.
Assists QM Director/Compliance Officer with Professional Advisory Committee and Compliance Committee preparation including meeting set up, invitations, PowerPoint’s and handouts and minutes.
Performs other related duties in the Quality Management/Compliance Department.