Quality Assurances Specialist
The Quality Assurance Specialist (QA Specialist) has knowledge of documentation standards for a variety of payer systems and expertise in CPT and ICD-10CM coding within a Behavioral Health Psychiatric outpatient practice environment. The primary responsibility is focused monitoring and billing reviews to ensure compliance with existing contracts. Results of reviews are submitted to the Quality Assurance Team Lead and Quality Assurance Supervisor, with summary results provided to the Compliance Committee. The QA Specialist may assist with making necessary edits or corrections to billing and documentation in the Ozark Center Electronic Medical Record. Additionally, the role requires a basic understanding of trauma-informed care to foster a sensitive and responsive work environment for individuals impacted by behavioral health issues.
Responsibilities
- Conduct assigned monitoring and audits prior to deadlines and share 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 for its remediation.
- Assist the Quality Assurance Supervisor during audits by external parties/payers.
- Remain up to date on contract documentation requirements.
- Perform other duties as assigned.
Requirements
- High school diploma or equivalent.
- A minimum of one (1) year of experience in a clinical/medical office.
- Knowledge of CPT and ICD-10CM coding in a Behavioral Health Psychiatric outpatient practice environment.
- Understanding of trauma-informed care principles.
Physical Requirements
- Normal office environment with prolonged sitting, frequent standing, bending, stooping, and occasional lifting up to 10 pounds.
- Requires normal range of hearing and manual dexterity sufficient to operate keyboard, telephone, photocopier, calculator, and other office equipment.
- Ability to work under stressful conditions and irregular hours.