Quality Assurance (Q/A) Auditor - Medical

Job Description

Job Description

Description:

Quality Assurance (Q/A) Auditor – Medical.

Location:
Houston, TX | Schedule : Full-Time, In-Person | Monday–Friday, 8 AM–5 PM (No Weekends)

ABOUT SENIOR PSYCHCARE:

Senior PsychCare provides comprehensive behavioral health services to residents in long-term care facilities throughout Texas and Louisiana. Our multidisciplinary team is committed to delivering high-quality psychiatric and psychological care while maintaining the highest standards of documentation, compliance, and patient care. 

We are currently seeking a Quality Assurance (Q/A) Auditor to join our growing Compliance and Quality Assurance Department. This position is responsible for reviewing provider documentation for quality, accuracy, and compliance with company standards, CMS regulations, and payer requirements while supporting provider education and continuous quality improvement. 

Key Responsibilities:

• Perform quality assurance audits of psychiatric and psychological provider documentation. 
• Conduct new provider audits and ongoing quality reviews to ensure compliance with company policies and regulatory requirements. 
• Review documentation for medical necessity, coding accuracy, diagnosis consistency, and documentation completeness. 
• Identify documentation deficiencies and communicate audit findings to providers in a professional and educational manner. 
• Track audit findings and maintain accurate audit records within internal systems. 
• Collaborate with Compliance, Clinical Leadership, and Regional Directors to improve documentation quality and workflow efficiency. 
• Assist with one-on-one provider education and documentation coaching as assigned. 
• Monitor trends identified through quality audits and communicate opportunities for improvement. 
• Maintain confidentiality while handling protected health information (PHI) in accordance with HIPAA regulations. 
• Participate in departmental quality improvement initiatives and special projects.

Qualifications:

Education:

• Associate’s or Bachelor’s degree in healthcare administration, Health Information Management, Nursing or a related field (preferred)
• Equivalent healthcare experience will be considered.  

Experience:

• Experience reviewing medical documentation, electronic health records (EHR/EMR), or healthcare quality preferred. 
• Behavioral health, psychiatry, psychology, long-term care, medical records, coding, or compliance experience is highly preferred. 
• Experience educating providers or healthcare staff is a plus. 
• Perfect opportunity for entry- to mid-level candidates.  

Skills: 

• Excellent attention to detail and strong analytical skills. 
• Ability to interpret clinical documentation and identify discrepancies. 
• Strong written and verbal communication skills. 
• Excellent organizational and time-management abilities. 
• Ability to manage multiple priorities in a fast-paced environment. 
• Proficient with Microsoft Office (Word, Excel, Outlook). 
• Ability to work independently while collaborating effectively with a multidisciplinary team.
  

Benefits:

• Paid Time Off and Paid Holidays
• Comprehensive health benefits including Medical, Dental, and Vision
• 401(k) Retirement Plan with company match
• Long-Term and Short-Term Disability
• Life Insurance
• Healthcare coverage effective the 1st of the month following full-time employment

If you are passionate about improving documentation quality, supporting providers, and making a meaningful impact in behavioral healthcare, we'd love to hear from you!

Requirements: