[New Job Opening] Quality Assurance Specialist I job Vacancy in Remote


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Job Details:
Position Name :
Quality Assurance Specialist I
Job ID :
Description : Centauri Health Solutions provides technology and technology-enabled services to payors and providers across all healthcare programs, including Medicare, Medicaid, Commercial and Exchange. In partnership with our clients, we improve the lives and health outcomes of the members and patients we touch through compassionate outreach, sophisticated analytics, clinical data exchange capabilities, and data-driven solutions. Our solutions directly address complex problems such as uncompensated care within health systems; appropriate, risk-adjusted revenue for specialized sub-populations; and improve access to and quality of care measurement. Headquartered in Scottsdale, Ariz., Centauri Health Solutions employs 1700 dedicated associates across the country. Centauri has made the prestigious Inc. 5000 list since 2019, as well as the 2020 Deloitte Technology Fast 500™ list of the fastest-growing companies in the U.S. For more information, visit www.centaurihs.com.
Role Summary:
The Quality Assurance Specialist uses knowledge and experience to conduct quality reviews on inbound and outbound calls made by the Risk Adjustment Schedulers to validate client standards are met in addition to HIPAA compliance. The Quality Assurance Specialist conducts quality reviews of individual medical record technicians to validate the accuracy of the medical records being processed. In addition to image review, this role will also be responsible for expansion of QA in other areas of the business with the guidance and direction from leadership.
Role Responsibilities:
Completes Scheduler and Indexing QA training to acquire necessary skills for QA review
Listen to Schedule calls and complete correlating scorecard
Use applications such as, but not limited to, Call Miner, Livevox, and Centauri Advance to complete call review
Completes standard QA on image quality of retrieved medical records and accuracy of medical record technicians in processing the records
Creates and implements QA programs to support service line needs with Leadership including, but not limited to medical records, scheduling, and retrieval activities, indexing and additional client-specific project support as needed
Works with leadership to create and implement quality tools
Assists with initial and refresher training sessions and 1 on 1 training for new hires
Assists with productivity reporting as needed
Assist with daily reporting within Centauri Advance as needed
Prepare and provide coaching notifications to appropriate supervisors / team leads with appropriate feedback loop to validate the effectiveness of the corrective actions taken
Process records and documentation according to Centauri Health Solution standards
Adhere to all HIPAA standards and Hi-Trust regulations
Performs reporting and querying activities, processes daily/weekly/monthly productivity and progress reporting as needed with supervision
Conducts audits
Supports Business Process Improvement initiatives, reviewing processes and identifying weaknesses, gaps, and opportunities
Works with other to operationalize call quality findings
Works with others to operationalize chart image review findings
Works with Trainer and Leadership to identify program / process training needs
Works with leadership and others to standardize process across service line
Assists service line with processing issues as needed
Serves as a resource on process, quality, and automation
Identifies and supports implementation of operational, process or system enhancements needed to improve process efficiency or quality
Updates leadership on activities, issues, and concerns
Serves as a key driver of project plans for improving and automating process and quality
Understands and agrees to role-specific information security access and responsibilities
Ensures safety and confidentiality of data and systems by adhering to the organizations information security policies
Reads, understands, and agrees to security policies and complete all annual security and compliance training
Manage other duties as assigned.
Role Requirements:
Knowledge of quality standards for medical records
Familiar with components of the various types of and core data elements contained in standard Medical Records
Basic understanding of our Centauri’s service line databases and workflow processing tools/applications
Operation account processing
Microsoft Excel, Word, and Outlook skills
Strong organizational, problem solving and project management skills
Associate degree or equivalent experience
We believe strongly in providing employees a rewarding work environment in which to grow, excel and achieve personal as well as professional goals. We offer our employees competitive compensation and a comprehensive benefits package that includes generous paid time off, a matching 401(k) program, tuition reimbursement, annual salary reviews, a comprehensive health plan, the opportunity to participate in volunteer activities on company time, and development opportunities.
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