POSITION TITLE: Quality Control Specialist

REPORTS TO: Program Director

DIVISION: Housing (Permanent Supportive Housing) GRADE: 4

Position Purpose

The Quality Control Specialist will manage all quality assurance activities under the Permanent Supportive Housing Program. Responsibilities include developing and implementing quality assurance policies, conducting tests and random/routine assessments, identifying production, process, or contract compliance issues, and presenting solutions. They will support the Medicaid billing process through verification of data and billing preparation. In addition, they will attend the necessary training to ensure compliance with Medicaid billing and will attend community engagement, staff development and other special programs as required by E/BFSC.

Specific Duties and Responsibilities

Quality Assurance and Data Management

Prepares and implements quality assurance policies and procedures; Performs routine/random assessments and quality tests; Identifies and resolves workflow and production issues; Ensures that standards and contract regulations are observed; Documents quality assurance activities and creating audit reports and makes recommendations for improvement; Creates training materials and operating manuals and facilitates training sessions for team members on various data platforms, data training materials and operating manuals. Ensures accuracy and completeness of records; Reviews program participant records to verify proper Medicaid coding and completeness and makes corrections as required; clarification as necessary; Verifies all data is accurate in preparation for monthly billing; Works with accounting team to resolve rejections and billing discrepancies (85%)

Training and Professional Development

Identify and attend trainings and professional development activities to increase knowledge and skills relevant to this position, including those provided by DHS, E/BFSC and other entities; Apply and disseminate acquired knowledge and skill sets among colleagues and program participants; Attend supervision on a regular basis; Participate in annual performance evaluation and goal-setting for professional development; Identifies and participates in training to keep abreast of changes in Medicaid billing and reimbursement procedures; Keeps up to date on information required for remittance of Medicaid and communicates this information to team members (10%)

Community Engagement

Assist in the development and dissemination of program and organizational materials that highlight the services and programs of E/BFSC; Promote public participation and involvement by residents and community stakeholders in E/BFSC and other community events and E/BFSC events; Serve as a representative on behalf of E/BFSC at community-based events and meetings; Provide resource information for maintenance of a community resource database (5%)

Report any suspected abuse or neglect as mandated by law.

Perform other tasks as necessary and/or assigned by immediate supervisor.

Qualifications Required

• High School Diploma or GED Certificate required, bachelor’s degree in relevant field preferred.
• 2 years of quality assurance experience required.
• 2 years of experience in Medicaid coding or billing a plus
• Knowledge of relevant HSRA and Medicaid Billing regulatory standards
• Valid driver’s license, copy of driving record and proof of valid auto insurance.
• Police clearance and Child Abuse Registry clearance
• Preferred resident of E/BFSC serving area
• Health certification and TB screen

Skills and Competencies Required

• Integrity, discretion, and respect for confidentiality and privacy
• Excellent oral communication interpersonal, and customer service skills
• Demonstrated typing, computing, and data entry skills.
• Excellent analytical skills
• Ability to prioritize and work under pressure.
• Time management and organizational skills
• Demonstrated attention to detail.

Job Type: Full-time

Pay: Up to $65,000.00 per year

Benefits:

• 401(k)
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible schedule
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Parental leave
• Vision insurance

Schedule:

• 8 hour shift

Work setting:

• In-person

Shift availability:

• Day Shift (Preferred)
• Night Shift (Preferred)
• Overnight Shift (Preferred)

Work Location: In person