Quality Review Specialist

Ensures the correct procedural operation and flow of the care centers via auditing measures, reporting of data, and by ensuring ancillary billing functions are followed according to the policies, procedures and protocols set out by management. This role provides the tools and education necessary for care center staff to operate effectively and efficiently through in-depth knowledge of the day-to-day functions in the care center.

Job Responsibilities:

· Conduct audits and compliance checks on clinic staff charting, coding, and document placement on a regular and established audit schedule.

· Audit patient records for completeness, accuracy, and appropriateness according to the latest policies. The audits may include but not be limited to ensuring records include the minimal required data, comparing source data to the records for accuracy, coding, and analyzing select data in detail.

· Maintain detailed auditing findings, recommendations, and corrections and monitor and follow up on requested audit corrections to ensure they have been completed.

· Report audit findings, recommendations, and corrections to Practice Managers or others as necessary.

· Gather ancillary services billing data to report to Accounting for client invoicing deadlines.

· Responsible for various weekly, monthly and quarterly production of reports from the EMR system.

· Updating of core fields in reports is required on a yearly or otherwise needed basis.

· Collaborate closely with team members by understanding their objectives to enhance reports for the needs of the company.

· Writing, editing, and verifying data in reports to ensure clarity, conciseness, correctness, and delivery of reports in a timely fashion.

Professional Competencies

· Excellent written and oral communication.

· Close attention to detail.

· Strong organizational skills.

· Positive relationship management skills.

· Ability to work individually and as a team member.

Physical Requirements:

• Close and distant vision.

• Frequently sitting with some walking and standing.

• Frequently lift / carry up to 40 lbs.

• Continual use of manual dexterity and gross motor skills with frequent use of bi-manual dexterity and fine motor skills.

Working Conditions:

• Office hours are from 8:00 am to 5:00 pm. This is not a remote position.

• Continual work in normal office conditions.

• Phone and computer use.

Qualifications:

· High School Diploma or GED.

· 3 years of experience working in healthcare.

· 3 years of experience using an EMR system required.

· Ability to exhibit high knowledge base of eCW and/or Epic required.

· Understanding Query Studio in eCW is preferred.

· Experience in writing reports is preferred.

· Billing/coding knowledge is preferred.

· Demonstrated proficiency in Microsoft Office products, including Word, Excel, and PowerPoint.

Job Type: Full-time

Pay: $21.83 - $23.94 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday
• No weekends

Experience:

• eCW: 2 years (Preferred)
• Query Studio: 2 years (Preferred)
• coding/billing: 2 years (Preferred)

Work Location: In person

Salary : $22 - $24