Quality Assurance Coordinator Substance Use/Mental Health
1 month ago
QUALITY ASSURANCE COORDINATOR
Position Title: Quality Assurance Coordinator
Location: Hybrid/ Woodland Hills
Department: Quality Assurance
Reports To: Director of Revenue Cycle
Position Type: Full Time/ Salary
Job Summary:
The Quality Assurance Coordinator, for Behavioral Health and Addiction Medicine, is responsible for evaluating the quality of patient care documentation and ensuring compliance with current laws and regulations. This role focuses on process improvements and the implementation of clinical best practices. Additionally, the Quality Assurance Coordinator may be required to train staff on new or improved clinical practices.
Key Responsibilities:
-Documentation Review: Evaluate patient care documentation for consistency and accuracy with the Comprehensive SOC/RC/ROC/DC OASIS Assessment and Plan of Care. Ensure the discipline frequency aligns with assessment data.
-OASIS Management: Process all OASIS submissions in a timely manner, including data transfers, ROC, RC, follow-up visits, and OASIS discharges. Ensure data accuracy and compliance with established standards.
-Quality of Care Review: Monitor charts for quality of care rendered, including orders followed and appropriate contact with physicians and other disciplines. Resolve any charting issues promptly.
-Policy Compliance: Monitor adherence to policies and procedures, particularly those related to clinical documentation and best practices. Ensure familiarity and compliance with HIPAA regulations.
-Proficiency in ICD-10 Coding and OASIS E: Demonstrate proficiency in diagnosis coding using ICD-10 and OASIS E to ensure accurate and compliant documentation.
-Issue Resolution: Identify and resolve charting and documentation issues in a timely and effective manner to maintain high standards of patient care.
Staff Training and Development: Participate in the development of in-services and individual clinician training sessions. Assist in training staff on new or improved clinical practices and ensure understanding and compliance with quality standards.
Continuous Improvement: Collaborate with clinical and administrative teams to identify areas for improvement in clinical practices and processes. Provide feedback and recommendations for enhanced quality and efficiency.
Recordkeeping and Reporting: Maintain accurate records and documentation related to quality assurance activities. Prepare reports and summaries for management review including racking daily client service hours
Conduct detailed audit on a regular basis as defined by compliance requirements and provide additional education or training as necessary.
Job Requirements:
Experience in Behavioral Health and/ Addiction Medicine
Minimum of 2 years of Quality Assurance (QA) or Performance Improvement (PI) experience required.
Preferred: 2 years of progressive management experience.
Proficiency in Microsoft Office applications.
Ability to efficiently lead and motivate a clinical team
Perform internal audits of medical record documentation and review claims billed to Insurance.
Develop and conduct educational documentation and training for clinicians to ensure compliance with guidelines from CMS and health plan standards.
Prepare formalized reports from audit results and present findings to leadership.
Independently respond to inquiries from physicians, executive leaders, and other staff regarding billing and documentation.
Develop educational programs for providers based on audit findings and provide general education on documentation rules and regulations.
Perform follow-up reviews after initial training and determine the need for additional education.
Communicate regularly with leadership to ensure timely receipt of necessary information.
Collaborate with directors, managers, and supervisors to address specific issues and training requests.
Qualifications:
Strong knowledge of OASIS E and ICD-10 coding.
Knowledge of Joint Commission and DHCS regulations
Familiarity with HIPAA regulations and compliance requirements.
Ability to use clinical EHR systems
Excellent attention to detail and analytical skills.
Strong communication and interpersonal skills.
Ability to train and mentor staff on clinical practices and quality standards.
Problem-solving and critical-thinking abilities.
Previous experience in quality assurance or clinical documentation preferred.
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