Quality Control Analyst

AmeriBest Home Care; Philadelphia (Philadelphia County); On-site; USD 65,000 - 90,000; Full time

Job summary

AmeriBest Home Care in Philadelphia seeks a Quality Control Analyst to audit and evaluate the quality of our services, analyzing workflows and data to measure compliance with internal policies and industry regulations. The role reports to the Chief Compliance Officer and collaborates with the Quality Control Administrator.

The position requires independence, strong MS 365 skills, and the ability to prepare comprehensive audit reports, using time records, billing, payroll, and eligibility data to

Qualifications

• Bachelor’s degree in a business-related field or equivalent preferred.
• Advanced computer skills with Microsoft 365—Excel, Word, Outlook, SharePoint, Teams.
• Ability to interpret regulations and guidance documents and apply critical thinking to compliance requirements.
• Detail oriented with strong verbal and written communication.

Responsibilities

• Perform independent control testing and auditing activities and document results.
• Analyze data to identify trends related to quality.
• Develop and maintain quality control procedures and testing scripts.
• Collaborate with cross-functional teams to resolve quality issues and implement corrective actions.
• Prepare detailed audit reports on quality control activities and results.
• Review time records, billing and payroll data to confirm processes were followed.

Skills

Regulatory understanding

Critical thinking

Attention to detail

Verbal and written communication

Independent work

Education

Bachelor’s degree in business-related field

Tools

Microsoft 365 (Excel, Word, Outlook, SharePoint, Teams)

Job description

AmeriBest Home Care provides quality in-home care to our clients. The Quality Control Analyst is a crucial member of the AmeriBest team for ensuring the quality of our services by conducting audits and evaluations.

Reporting to the Chief Compliance Officer, and working closely with the Quality Control Administrator, it is the Quality Control Analyst’s responsibility to analyze operational workflows and data to measure and evaluate our compliance with internal policies and industry regulations. The success of the Quality Control Analyst will be measured by productive completion of audits, effective presentation of each audit’s results, and successful implementation of corrective action plans to improve quality and compliance.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Perform independent control testing and auditing activities and document results
• Analyze data and information to identify trends and patterns related to quality
• Develop and maintain quality control procedures and protocols; support the refinement of testing scripts
• Collaborate with cross-functional teams to resolve quality issues and implement corrective actions
• Prepare detailed audit reports on quality control activities and results
• Analyze time records, Electronic Visit Verification data, billing records, payroll records, personnel files, authorization records, and other related data to confirm processes were completed correctly
• Educate other departments on discovered quality gaps
• Stay current with industry trends and best practices in quality control
• Assist in developing and maintaining issue management best practices
• Assist with gathering records to respond to external requests and audits
• Assist with Ad hoc projects as necessary
• Other duties as assigned

COMPLIANCE AS REQUIREMENT OF PERFORMANCE:

• All associates are expected to participate in any investigatory activities
• All associates are expected to report any violation of AmeriBest policies and procedures
• All associates are expected to conduct themselves in an ethical manner consistent with the AmeriBest mission statement and Standards of Conduct
• All associates are expected to protect the privacy of protected records and must conduct themselves consistent with all applicable laws and policies regarding privacy protection, including HIPAA and state specific privacy laws

COMPETENCIES/SKILLS (Required):

• Bachelor’s degree preferably in a business-related field
• Must have advanced computer skills - strong proficiency in Microsoft 365 including Excel, Word, Outlook, SharePoint, and Teams
• Must be able to comprehend regulations and guidance documents and apply critical thinking skills to evaluate requirements
• Must be detail oriented and able to effectively communicate verbally and in writing
• Able to work independently on projects with minimum oversight
• Able to safeguard confidential information
• Able to function effectively as a member of a team

PREFERRED EXPERIENCE (Not Required):

• Experience in Home Care Agency operations
• Familiarity with the HHAeXchange software system
• Experience with Microsoft Power BI or SQL tools
• Knowledge of Risk Management and Internal Audit concepts

PHYSICAL DEMANDS:

• Regular requirement to sit; use hands to touch, handle or feel
• Ability to work using a computer during entire shift
• Occasional requirement to stand; walk and reach with hands and arms
• Occasional requirement to lift and/or move up to 30 pounds
• Vision abilities include close vision, peripheral vision, depth perception and ability to adjust focus