Quality Assurance Specialist

The following statements are intended to describe the general nature and level of work being performed. They are not to be construed as an exhaustive list of all duties and responsibilities required of personnel so classified.

Position Summary

The Quality Assurance (QA) Specialist will participate as part of the Quality Assurance Team in conducting on-going reviews of electronic health records for all Enki sites.

Core Duties And Responsibilities

• Participate as part of the Quality Assurance Team in conducting on-going reviews of health records for all Enki sites by auditing:
• Accuracy and completeness of Medical Records documents including but not limited to Consent for Services/Release of Information/Medication Consents.
• Adherence to Medi-Cal, EPSDT, and Medicare regulations.
• Diagnostic criteria in Initial Assessment to confirm client's need for Specialized Mental Health Services (SMHS).
• Initial Medication Evaluation/Re-Assessment and medication services.
• Ensure plan for Subsequent Services are appropriate to diagnosis/Problem List/linkage needs/on-going treatment recommendations.
• Coordinated Services paperwork: Ensure timely completion of 6-month/annually required forms.
• Progress notes are relevant to impairments identified in Assessment/Needs Evaluation/Problem List.
• Accurate use of procedure codes as determined by the Department of Mental Health Procedure Codes Manual.
• Justification of time billed as evidenced by documentation of interventions.
• Admissions: All documentation completed; justification of Medical Service Necessity.
• Discharges: Appropriateness, follows procedures; referrals provided.
• Organize, coordinate, and maintain an accurate record of all QA reviews.
• Conduct regular follow-ups on any outstanding QA reviews to ensure timely completion.
• Follow HIPAA regulations to maintain strict client confidentiality.
• Prepare and present reports as requested.
• Make training recommendations based on chart reviews.
• Assist in special projects, audit preparing and audit responses as needed.
• Meet with supervisor on a routine basis.
• Other duties as assigned.
• Comply with all Company policies and procedures as applicable.
  

Minimum Education And Experience Preferred

• High school diploma plus two (2) years experience in a mental health setting; or Bachelors Degree from accredited college/university in a related field (i.e. social work, human services, psychology or sociology).
• Minimum of two (2) years experience in Los Angeles County Department of Mental Health system preferred.
  
  

Licenses/Certifications

• Valid California driver's license, current automobile insurance, and eligibility to drive for the Company.
  
  

Knowledge, Skills And Abilities

• Knowledge of Medical and Psychiatric terminology and diagnostic codes.
• Knowledge of Medi-Cal Short Doyle Manual and Medicare rules, regulations and guidelines.
• Knowledge of Enki and/or Los Angeles County Department of Mental Health Quality Assurance procedures.
• Ability to perform duties in a positive, courteous, flexible and adaptive manner.
• Able to exercise independent judgment and initiative.
• Computer literate and experienced with computer programs such as Microsoft Office Word, Outlook and Excel.
• Experience using an Electronic Health Record database is a plus.
• Must be able to communicate clearly, both orally and written.
• Possesses excellent organizational skills and must be able to prioritize and complete multiple tasks.
  
  

Pay Range: $18.00 - $28.00/Hour (Determined by experience and Qualifications)

Physical Requirements

• See well enough (with or without corrected vision) to read fine print, hand-written materials, and a computer screen.
• Speak and hear well enough (with or without assistive device) to converse in person and by telephone.
• Finger, handle, feel, and reach with hands and arms, including ability to use a computer keyboard.
• Have the mobility (with or without assistive device) to stand, sit, crouch, and move from one work area to another.
• Have the strength to lift, carry or push office equipment and supplies used in normal job functions up to 15 lbs.
• Stamina to effectively perform work activities.
  
  

Policy Statement

Enki Health Services Inc. is an equal opportunity employer with a standing policy of nondiscrimination. This means that all qualified persons are accorded an equal opportunity for employment or promotion without regard to race, color, creed, religion, sex, gender, gender identity, gender expression, sexual orientation, marital status, registered domestic partner status, age, pregnancy, national origin, ancestry, physical or mental disability, medical condition, genetic information, military and/or veteran status, or any other basis protected by applicable law.

Enki will comply with all fair employment laws and will take affirmative measures to eliminate or prevent illegal discrimination. It is the policy of Enki that positive action be taken to insure that members of protected classes have an equal opportunity for all jobs. Enki will comply with all requirements of the Americans with Disabilities Act (ADA).