Quality Assurance Specialist

MISSION STATEMENT:


We say yes to people seeking help for addiction and mental health. We create pathways to recovery and purpose. We provide the right service at the right time, delivered by people with lived experience. We transform behavioral health systems through innovation, creativity and collaboration.

JOB DESCRIPTION:

The Quality Assurance Specialist oversees various areas of billing and documentation for compliance to contractual obligations with various mandates and State laws, rules, regulations, sub-contractual agreements, HIIPA, Medicaid, agency policy and procedures to provide training and feedback to service delivery staff on areas of needed correction/ improvement. Additionally, the Quality Assurance Specialist will work collaboratively with supervisors and management staff to ensure the accuracy and quality of client documentation, client services, records and documentation within the agency.

DUTIES AND RESPONSIBILITIES:

• Responsible for the review and content compliance of all documentation submitted to the SUD client record, including, but not limited to: intake documents, assessments, client treatment plans, progress notes, change of diagnoses, outcome measures, collateral documents, and correspondence.
• Ensures that the "Golden Thread" of medical necessity is documented within the client record in accordance with TNR and State policy and procedures.
• Answer telephone inquiries and/or refer to appropriate staff, return messages
• Data Entry intake packet into EHR
• Acquire service Authorization through the Medicaid site
• Enter in Authorization in EHR
• Create paper and electronic records for all clients
• Maintain inactive files keeping them in proper order, shredding any unnecessary documents
• Assist program manager, specialists, and executive director in any proofreading, data entry, clerical work as requested
• Use general office equipment such as copy machines, printers, and facsimile machines
• Maintaining confidentially according to regulations and policy
• Perform all other duties as assigned

JOB SPECIFICATIONS:

• Must have computer skills, including spreadsheet, word processing and publishing programs
• Excellent written and verbal communication skills with good vocabulary, spelling, and proofreading skills
• Strong research skills
• Strong customer service and interpersonal skills
• Demonstrated ability to work independently and with limited supervision
• Demonstrated ability to coordinate multiple activities

MINIMUM QUALIFICATIONS:

• High School Diploma or GED preferred
• Minimum 6 months experience in administrative support or clerical field
• Experience with Microsoft applications and basic computer programs
• Lived experience with addiction and be in recovery

PREFERRED QUALIFICATIONS:

• Prior experience in customer service
• Prior experience with electronic health records system

FULL TIME BENEFITS:

• ICHRA Coverage for Employee Health Insurance Policy Reimbursement (Health Insurance Policy Reimbursement)
• 401K Plan - 100% Match Up To 5%
• Life & ADD Insurance Policy 100% covered by employer
• Vision and Dental Policy 90% covered by employer
• 10 Paid Holidays a Year
• Paid Time Off Accrual
• Paid Training and Credentialing
• Short term and long-term disability
• Monthly cash stipend
• Supplemental benefits including: critical illness insurance, accident insurance and hospital indemnity

AT-WILL EMPLOYMENT

The relationship between you and the True North Recovery Inc. is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or the True North Recovery Inc. . No representative of True North Recovery Inc. has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status.