What are the responsibilities and job description for the Quality Assurances Specialist position at Ozark Center?
Job Description Summary: 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.
Education: High school diploma or equivalent.
Work Experiences: A minimum of one (1) years experience in clinical/medical office.
Responsibilities
Physical Requirements
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.
Education: High school diploma or equivalent.
Work Experiences: A minimum of one (1) years experience in clinical/medical office.
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.
Physical Requirements
- Normal Office environment.
- Typical physical demands include 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 as needed.
- Requires ability to work under stressful conditions and to work irregular hours.