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Title

Quality Assurance Specialist 

EOE StatementWe are an equal employment opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, national origin, disability status, protected veteran status or any other characteristic protected by law.
 
Description

Summary Position Statement:

The Quality Assurance (QA) Specialist is responsible for management for the Therap client services database including general maintenance, Individualized service plan setup, and auditing service delivery notes each billing cycle to ensure the information is accurate and complete. This position will prepare reports and work with management employees to resolve service delivery and billing data concerns each billing cycle. The QA Specialist will provide group and individualized user training on the Therap database for all employees as requested.

Essential Functions:

  • Reviews and analyzes Therap notes entered into the Therap on-line system to ensure that Medicaid billing data is complete and has been entered accurately for all services provided each pay period.

  • Works with Staff Managers to ensure that all Therap notes are entered in a timely manner and corrections are completed each pay period.

  • Verifies Therap note compliance with Medicaid approved Plans of Care and/or grant limitations to ensure that all direct care services provided are eligible expenses.

  • Will monitor non-eligible service notes and notify the Quality Assurance Analyst if a pattern of excessive non-eligible service notes is identified.

  • Assists the Quality Assurance Director with making adjusts in software data to ensure that all components of Therap are timely, accurate and utilized to the best of the agency's advantage (for example, that ISP programs are active).

  • Provides classroom instruction and individualized training and technical support for employees on the Therap and Scheduling software systems as requested.

  • Provides a full range of administrative support for departments, and external auditors as assigned by Quality Assurance Analyst.

  • Assists accounting in maximizing the available systems to ensure the billing function is accurate, timely, and efficient as requested.

  • Create reports and run data analysis as directed.

  • Responsible for on-going development and maintaining the Therap client service database to meet REACH's changing needs.

  • Responsible for setting up all new clients in the Therap system and updating personal and plan of care information as needed.

  • Assist with maintenance of the scheduling software system as requested.

  • Maintain the hard copy and electronic Medicaid waiver and ILP files in compliance with regulations.

  • Monitor and provide employee training to improve medication records.

  • Will assist the Quality Assurance Director in audit related activities as requested.

  • Attend and participate in training, staff meetings, and serve on special committees as requested.

  • Maintain confidentiality.

  • Other duties as assigned

 
Position Requirements

Position Requirements:

  • Must be at least 21 years of age.

  • Bachelor’s Degree in related field

  • Driver License

  • 2yrs experience of advanced administrative experience with emphasis in database management and auditing.

    Substitution: Additional qualifying administrative experience may be substituted for the Bachelor’s degree on a year for year full-time equivalency basis.

    Minimum Knowledge, Skills & Abilities:

  • Excellent written and oral communication skills including public speaking

  • Ability to work independently and in a team environment

  • Ability to analyze data from multiple sources

  • Excellent time management and organizational skills

  • Knowledge of disability issues, benefits, programs and practices

  • Excellent computer skills including al MS Office programs

  • Ability to use Windows 2000 environment

    Physical Requirements:

    This position will work primarily in an office environment requiring a full range of motion including standing, walking, bending, and twisting. This position will spend a significant amount of time using a computer requiring visual acuity, color definition, and dexterity in fingers/hands. This position may at times require employees to transition between interior work spaces including but not limited to exposure to the elements, walking on uneven ground, and the ability to drive a vehicle.

 

This position is currently accepting applications.

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