Quality Assurance Specialist

True North Recovery Inc.; Wasilla (AK); On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

401K match

Health insurance

Life & AD&D insurance

Vision & dental insurance

Paid holidays

Paid time off

Training & credentialing

Short-term & long-term disability

Monthly cash stipend

Supplemental benefits

Job summary

True North Recovery Inc. in Wasilla, AK seeks a Quality Assurance Specialist to oversee billing and documentation for compliance with Medicaid, HIIPA, and state mandates, providing training to service delivery staff and ensuring accuracy of client records.

You will review intake documents, assessments, treatment plans, progress notes and ensure medical necessity is documented as required by policy and procedures. Strong attention to detail and communication skills are essential.

Qualifications

• Must have computer skills, including spreadsheet, word processing and publishing programs.
• Excellent written and verbal communication skills with good vocabulary, spelling, and proofreading skills.
• Strong research skills
• Strong customer service and interpersonal skills
• Demonstrated ability to work independently and with limited supervision
• Demonstrated ability to coordinate multiple activities

Responsibilities

• Review and ensure content compliance of all documentation in the SUD client record (intake, assessments, treatment plans, progress notes, change of diagnoses, outcomes).
• Ensure medical necessity is documented per policy and procedures.
• Answer telephone inquiries and/or refer to appropriate staff; return messages.
• Data entry into EHR; acquire and record Medicaid service authorizations.
• Create paper and electronic records for all clients; maintain inactive files.
• Assist program staff with proofreading, data entry, and clerical tasks as requested.

Skills

Computer skills

Communication skills

Research skills

Customer service

Independence

Multi-tasking

Education

High School Diploma or GED

Tools

Microsoft Office

EHR systems

Job description

MISSION STATEMENT

We say yes to people seeking help for addiction and mental health. We create pathways to recovery and purpose. We provide the right service at the right time, delivered by people with lived experience. We transform behavioral health systems through innovation, creativity and collaboration.

JOB DESCRIPTION

The Quality Assurance Specialist oversees various areas of billing and documentation for compliance to contractual obligations with various mandates and State laws, rules, regulations, sub-contractual agreements, HIIPA, Medicaid, agency policy and procedures to provide training and feedback to service delivery staff on areas of needed correction/ improvement. Additionally, the Quality Assurance Specialist will work collaboratively with supervisors and management staff to ensure the accuracy and quality of client documentation, client services, records and documentation within the agency.

DUTIES AND RESPONSIBILITIES

• Responsible for the review and content compliance of all documentation submitted to the SUD client record, including, but not limited to: intake documents, assessments, client treatment plans, progress notes, change of diagnoses, outcome measures, collateral documents, and correspondence.
• Ensures that the “Golden Thread” of medical necessity is documented within the client record in accordance with TNR and State policy and procedures.
• Answer telephone inquiries and/or refer to appropriate staff, return messages
• Data Entry intake packet into EHR
• Acquire service Authorization through the Medicaid site
• Enter in Authorization in EHR
• Create paper and electronic records for all clients
• Maintain inactive files keeping them in proper order, shredding any unnecessary documents
• Assist program manager, specialists, and executive director in any proofreading, data entry, clerical work as requested
• Use general office equipment such as copy machines, printers, and facsimile machines
• Maintaining confidentially according to regulations and policy
• Perform all other duties as assigned

JOB SPECIFICATIONS

• Must have computer skills, including spreadsheet, word processing and publishing programs
• Excellent written and verbal communication skills with good vocabulary, spelling, and proofreading skills
• Strong research skills
• Strong customer service and interpersonal skills
• Demonstrated ability to work independently and with limited supervision
• Demonstrated ability to coordinate multiple activities

MINIMUM QUALIFICATIONS

• High School Diploma or GED preferred
• Minimum 6 months experience in administrative support or clerical field
• Experience with Microsoft applications and basic computer programs
• Lived experience with addiction and be in recovery

PREFERRED QUALIFICATIONS

• Prior experience in customer service
• Prior experience with electronic health records system

FULL TIME BENEFITS

• ICHRA Coverage for Employee Health Insurance Policy Reimbursement (Health Insurance Policy Reimbursement)
• 401K Plan - 100% Match Up To 5%
• Life & ADD Insurance Policy 100% covered by employer
• Vision and Dental Policy 90% covered by employer
• 10 Paid Holidays a Year
• Paid Time Off Accrual
• Paid Training and Credentialing
• Short term and long-term disability
• Monthly cash stipend
• Supplemental benefits including: critical illness insurance, accident insurance and hospital indemnity

AT-WILL EMPLOYMENT

The relationship between you and theTrue North Recovery Inc.is referred to as "employment at will." This means that your employment can be terminated at any time for any reason, with or without cause, with or without notice, by you or theTrue North Recovery Inc.. No representative ofTrue North Recovery Inc.has authority to enter into any agreement contrary to the foregoing "employment at will" relationship. You understand that your employment is "at will," and that you acknowledge that no oral or written statements or representations regarding your employment can alter your at-will employment status.