Quality Assurance / Report Compliance Reviewer

Job Description

Job Description

Position Summary

Reviews completed Consultative Examination Reports and Medical Record Review Reports for completeness, internal consistency, and compliance with District and SSA documentation standards prior to submission.

Key Responsibilities

• Personally review each Consultative Examination Report to confirm it bears a legible signature from the examining provider, with the provider's name typed at the end of the report.
• Verify each report adequately addresses the District's referral question(s), is internally consistent, and is consistent with other case information and claimant statements.
• Confirm reports meet the documentation standards required for the SSA disability program.
• Flag deficient reports for correction prior to submission through ERE, and track turnaround against the 10/14-calendar-day deadlines.
• Maintain claimant information in strict confidence in both electronic and hard-copy form.

Minimum Qualifications

• Bachelor's degree in health information management, nursing, or related clinical field.
• Experience in medical records quality review or utilization review.
• Strong attention to detail and familiarity with disability documentation standards.