Quality Assurance Specialist

Ensuring the accuracy and compliance of Medicare and Medicaid claims, the full-time Quality Assurance Specialist will perform detailed reviews of patient care reports, validate documentation, and confirm adherence to regulatory requirements in a remote setting. Key responsibilities Conduct thorough quality reviews of Medicare/Medicaid claims post-coding to ensure accuracy and compliance Examine patient care reports to verify documentation supports billed services and meets payer standards Collaborate with internal teams to address documentation issues and support continuous quality improvement initiatives Required qualifications High School Diploma or equivalent required; clinical or medical background preferred (LPN, RN, EMT, etc.) Strong understanding of medical terminology, EMS clinical documentation, and healthcare billing standards Ability to efficiently navigate multiple computer programs simultaneously Reliable home internet with speeds of 15 Mbps or higher Excellent attention to detail and strong time management skills in a remote work environment