Quality Assurance (QA) Specialist

HealthGrades Analytics; Houston (TX); On-site; USD 28,000 - 33,000; Part time

Benefits offered by this job

Mileage reimbursement

Professional development opportunities

Job summary

HealthGrades Analytics in Houston, TX seeks a part‑time HGB Program Quality Assurance Specialist to audit patient encounters and ensure Medicare compliant documentation before claims submission. The role emphasizes attention to detail, documentation standards, and timely communication with providers. Travel across Texas is required.

The ideal candidate will have at least 2 years in a clinical setting, plus 1 year with Medicare guidelines and quality metrics, and strong communication skills.

Qualifications

• Minimum 2 years of experience working in a clinical setting.
• Minimum 1 year of experience working with Medicare guidelines, documentation requirements, and quality metrics.
• Strong understanding of clinical documentation standards.
• Exceptional attention to detail.
• Strong written and verbal communication skills.
• Ability to prioritize multiple tasks while meeting deadlines.
• Willingness to travel throughout Texas as needed.

Responsibilities

• Audit 100% of patient encounters for documentation accuracy and completeness.
• Review all documentation before claims are submitted to ensure billing readiness.
• Verify that required clinical documentation supports all services performed.
• Ensure compliance with Medicare regulations, documentation standards, and company protocols.
• Identify documentation deficiencies and communicate required corrections to providers and clinical staff.
• Monitor quality trends and recommend process improvements.
• Maintain detailed QA audit logs and reporting.
• Participate in ongoing quality improvement initiatives.
• Travel throughout Texas as needed to support clinic audits and training.

Skills

Clinical documentation review

Medicare compliance

Critical thinking

Problem-solving

Organization

Time management

Microsoft Office proficiency

Tools

EMR/EHR systems

Job description

Position Summary:

The HGB Program Quality Assurance Specialist plays a critical role in ensuring every patient encounter is documented accurately and completely prior to claim submission. This position serves as the final quality checkpoint by auditing medical documentation, validating compliance with Medicare guidelines, and ensuring operational excellence across all HGB program locations.

The ideal candidate is highly detail-oriented, experienced in clinical documentation, and understands the importance of compliance, quality, and accurate reimbursement.

Primary Responsibilities:

• Audit 100% of patient encounters for documentation accuracy and completeness.
• Review all documentation before claims are submitted to ensure billing readiness.
• Verify that required clinical documentation supports all services performed.
• Ensure compliance with Medicare regulations, documentation standards, and company protocols.
• Identify documentation deficiencies and communicate required corrections to providers and clinical staff.
• Monitor quality trends and recommend process improvements.
• Maintain detailed QA audit logs and reporting.
• Participate in ongoing quality improvement initiatives.
• Travel throughout Texas as needed to support clinic audits and training.

Qualifications:

Required:

• Minimum 2 years of experience working in a clinical setting.
• Minimum 1 year of experience working with Medicare guidelines, documentation requirements, and quality metrics.
• Strong understanding of clinical documentation standards.
• Exceptional attention to detail.
• Strong written and verbal communication skills.
• Ability to prioritize multiple tasks while meeting deadlines.
• Willingness to travel throughout Texas as needed.

Preferred:

• Experience with EMR/EHR systems.
• Medical coding or billing knowledge.
• Quality assurance or auditing experience.

Skills:

• Clinical documentation review.
• Medicare compliance.
• Critical thinking.
• Problem-solving.
• Organization.
• Time management.
• Microsoft Office proficiency.

Compensation & Benefits:

• $20.00–$24.00 per hour.
• Part-Time position with growth opportunities.
• Mileage reimbursement for approved travel.
• Professional development opportunities.