Medical Quality Assurance Specialist I

QTC Management, Inc. in; Philadelphia (Philadelphia County); Remote; USD 50,000 - 70,000; Full time

Job summary

Join a dedicated team as a Medical Quality Assurance Specialist I, where you'll play a crucial role in ensuring accurate medical documentation for veterans. This remote position focuses on reviewing reports from medical providers, requiring strong knowledge of anatomy and medical terminology. Ideal candidates will have experience in healthcare settings and a commitment to quality assurance.

Benefits

Health and Wellness programs

Paid Leave

Retirement plans

Qualifications

• High School Diploma or equivalent required.
• Strong understanding of anatomy and medical terminology.
• Experience working with medical providers and understanding of medical coding.

Responsibilities

• Review and audit exam reports from medical providers.
• Ensure medical coding is complete and accurate.
• Coordinate with medical providers for report clarifications.

Skills

Anatomy knowledge

Medical terminology

Clinical reasoning

Analytical skills

Education

High School Diploma or equivalent

Tools

Case management software

Electronic medical records

Job description

Medical Quality Assurance Specialist I (Healthcare)

Do you crave a career that truly makes an impact in people's lives? Do you thrive on problem-solving and finding solutions? Join a dedicated, tight-knit team that creates an immediate and meaningful impact every day

Leidos QTC Health Services is seeking a Medical Quality Assurance Specialist on our Veteran Affairs Services team. You will work closely with medical providers and the Veterans Administration to ensure the documentation process is complete and accurate. In this role, you will review documentation sent over from medical providers and ensure the report is complete, concise, clear, and correct and the provider has accurately completed the Disability Benefit Questionnaires for delivery back to the VA.

Primary Responsibilities:

• Review and audit exam reports sent over from medical providers
• Ensure all medical coding is complete and accurate
• Ensure all tests have been ordered and completed, and present in the medical record
• Coordinate with medical providers as needed for clarification of reports
• Work with our in house appointment schedules to request additional appointments for the veteran as necessary

Required Qualifications:

• High School Diploma or equivalent (GED)
• Strong knowledge and understanding of anatomy and medical terminology
• Ability to read and analyze medical reports
• Aptitude to apply clinical reasoning (diagnostic testing)
• Ability to write clear questions to submit to the provider
• Experience working with medical providers (credentialing, medical coding, chart audits, triage, scribe, nursing)
• Understanding of case management software, electronic medical records and medical databases
• Must be able to successfully pass National Agency Check with Inquiries (NACI) background investigation

Preferred Qualifications:

• Allied medical professional certification, or relevant college, or vocational training in the medical field, i.e. LVN, CNA, Military Corpsman/Medic, EMT, MA, etc.
• Direct healthcare experience in medical case management or quality assurance to include the review of complex multi-focal medical reports for quality, clarity, thoroughness and insightful medical explanation
• Experience assisting with medical tests, treatments and procedures
• Knowledge of military medical examinations or experience working with the VA
• Understanding of general disability claims, workers compensation, or audits

Additional Information:

• Location: Remote - East Coast Only
• Training: 6 - 8 months of training period that includes coaching, mentorship, and proficiency verification. Upon graduation from training, an 8% pay increase is awarded.
• Probationary Period: Employment as a Medical QA Specialist will include successful completion of 120-day probationary period during which you will be given objectives to achieve. This timeframe lets you assess your readiness for the position as well as allows Leidos QTC Health Services to determine your ability to successfully perform the job. You will be provided objectives, documentation, training and performance feedback during the 120-day probationary period as part of your assimilation to the role. After successfully completing the 120-day probationary period, you will be removed from the probationary period.

Leidos QTC Health Services collaborates closely with government and non-government customers to address current and future program needs within the health services domain. We specialize in disability-focused medical examinations, independent medical exams and review services, occupational health services, diagnostic testing, and case management solutions. As innovators, we focus on advancing technologies that improve service delivery, with a particular emphasis on enhancing accessibility for examinees in rural communities. With a proven track record of continuous improvement and steady growth, we now handle over 2 million appointments annually. Visit www.qtcm.com for more information.

Compensation and Benefits

Pay and benefits are fundamental to any career decision. That's why we craft compensation packages that reflect the importance of the work we do for our customers. As a result, we offer meaningful and engaging careers to support you and your career goals, all while nurturing a healthy work-life balance. Employment benefits include competitive compensation, Health and Wellness programs, Income Protection, Paid Leave and Retirement. More details are available here.

This role may fall under the Service Contract Act (SCA), a federal law which provides for a U.S. Department of Labor-prescribed minimum prevailing rate of pay and certain benefit levels. Where appropriate, Company-provided benefit plans such as comprehensive leave, holiday, medical, dental, life, accident, disability coverages, retirement plan contributions, and other health and welfare benefits and payments are utilized to meet these obligations.

Commitment to Non-Discrimination

All qualified applicants will receive consideration for employment without regard to sex, race, ethnicity, age, national origin, citizenship, religion, physical or mental disability, medical condition, genetic information, pregnancy, family structure, marital status, ancestry, domestic partner status, sexual orientation, gender identity or expression, veteran or military status, or any other basis prohibited by law. Leidos QTC Health Services will also consider for employment qualified applicants with criminal histories consistent with relevant laws.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor.QA Compliance