Quality Assurance Documentation Specialist

POSITION SUMMARY: This position provides thorough review of services documented in the electronic health record to ensure accuracy, clarity, and compliance with Medicaid standards. The position requires an ability to attend to detail and communicate effectively with employees regarding their submitted service documentation as well as external auditing sources.

ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:

• Vigilant and comprehensive efforts to maintain confidentiality and security of protected health information, paper files and computer data.
• Extensive knowledge of the Alabama Medicaid requirements
• Provide training regarding service documentation to direct care staff.
• Perform quality assurance processes for service documentation to ensure it meets the standards set forth by Medicaid. This may include checking for spelling, grammar, ensuring information is clear and easy to understand, verifying accuracy of dates and times, etc.
• Communicate any identified issues with reviewed documentation to the employee completing the documentation. Follow up to ensure the employee has corrected any errors and resubmitted the service documentation.
• Identify employees in need of additional training and coordinate this training with the employee and/or their supervisor.
• Identify and communicate errors or issues requiring disciplinary action to employees with regard to service documentation.
• Participate in training as outlined in the Staff Development and Training Plan.
• Other duties as assigned by supervisor.

QUALIFICATIONS: Education, Experience, and Competencies

Education: Master’s degree in counseling, psychology, social work or related field.

Experience and Competencies: Position requires knowledge and experience with electronic health records. Should have knowledge of a variety of computer software applications in word processing, spreadsheets, database, and presentation software. Must possess a high level of interpersonal skills to handle sensitive and confidential information and situations. Position continually requires demonstration of poise, tact, and diplomacy. Some analytical ability is required in order to gather and summarize data for reports, find solutions to various administrative challenges, and prioritize work. The individual in an administrative support position should maintain attention to detail in composing, typing and proofing materials, establishing priorities and meeting deadlines. Basic knowledge of the laws, regulations, and standards related to the provision of behavioral health care must be developed. Should be familiar with behavioral healthcare terminology. The individual is trustworthy and able to maintain strict levels of confidentiality when dealing with clients, proprietary information, and sensitive situations. Must maintain a valid Alabama Driver License, submit to a background investigation, and complete an initial tuberculosis screening, as well as a physical health examination.

Language Skills: Ability to read, analyze, and interpret complex regulations and procedures; ability to respond effectively to inquiries or complaints from licensing agency representatives, staff, clients, and family members; ability to adapt communications to clients’ level of functioning; ability to relate to people at all levels of an organization. Possesses excellent interpersonal written and oral communication skills; knowledge of data processing and medical/behavioral health terminology is essential.

Mathematical Skills: Ability to utilize business mathematics and basic statistical/accounting processes.

AMERICANS with DISABILITIES ACT SPECIFICATIONS

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects tools, or controls; reach with hands and arms, climb stairs or steep and/or rough terrain; balance; stoop, kneel, or crouch; talk or hear; taste or smell. The employee must occasionally lift and/or move up to 10 pounds without assistance. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

WORK ENVIRONMENT: Work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is not substantially exposed to adverse environmental conditions. The noise level in the work environment is usually moderate. The employee is subject to hostile and emotionally upset clients, family members, staff, and visitors. The employee has a minimal risk of being exposed to infectious waste, diseases, conditions, etc., including exposure to the AIDS, hepatitis B, and tuberculosis viruses.

REQUIREMENTS

• Must be 21
• Masters Degree in Human Services i.e. Counseling, Psychology, Social Work or related field.

To provide the degree and quality of service in the least restrictive environment for our neighbor’s children that we would be compelled to provide for our own and to provide these services wherever possible in a manner that reflects the best of traditional and contemporary values embraced by families. Additionally, the program must strive to make itself accessible to families and agencies with varying abilities, mechanisms, and resources for funding services.