Quality Assurance / Report Compliance Reviewer

Professional Facility Services; Landover (MD); On-site; USD 62,000 - 78,000; Full time

Job summary

Professional Facility Services LLC is seeking a quality reviewer to evaluate Consultative Examination Reports and Medical Record Review Reports for completeness, accuracy, and SSA documentation standards before submission.

The role requires ensuring legible signatures, alignment with District referrals, and strict confidentiality of claimant information, with timely flagging for corrections and tracking deadlines in a secure environment.

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.

Responsibilities

• Review each Consultative Examination Report to confirm legible signature and typed provider name.
• Verify reports address the District's referral questions and align with case information and claimant statements.
• Ensure reports meet SSA disability documentation standards.
• Flag deficient reports for correction and track turnaround against 10/14 calendar-day deadlines.
• Maintain claimant information confidentially in electronic and hard-copy form.

Skills

Attention to detail

Disability documentation standards

Education

Bachelor's degree in health information management, nursing, or related clinical field

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.