Quality Assurance Specialist - Behavioral Health

Description

• SIGN-ON BONUS - Eligible to new & current employees of Interim Inc.

JOB DESCRIPTION

As a Quality Assurance Specialist, you'll be responsible for auditing client medical records to ensure compliance with Medi-Cal regulations, along with supporting Interim's commercial insurance clients by responding to inquiries, verifying insurance, and screening clients for appropriate program placements. This position prepares internal audit reports, facilitates targeted staff training, and conducts follow-up reviews to address chart deficiencies to mitigate fraud, waste, and abuse, thus protecting funding and maintaining documentation integrity. The incumbent will also participate in Medi-Cal documentation meetings at the Monterey County Behavioral Health Department to update staff and prevent funding disallowances through accurate record-keeping.

WHO WE ARE

Looking to make a difference? Our mission at Interim is to provide services and affordable housing to supporting members of our community with mental illness by building productive and satisfying lives in a world in which people with mental illness are able to live, work, learn and participate fully in the community. Join our team and instill hope in the community.

WHAT WE OFFER

HOW TO APPLY

To learn more about Interim and to apply for this position, please go to our website at

COMPENSATION

$38.01 - $49.50 per hour. Non-exempt; 20 hours / week; Eligible for overtime. Compensation based on education and experience.

REPORTS TO

Quality Assurance Supervisor

QUALIFICATIONS

Required : Master's degree in social work, psychology or related mental health field, plus be licensed (or be licensed within two years) as Clinical Psychologist, Licensed Clinical Social Worker, Marriage and Family Therapist, or Professional Clinical Counselor; at least two years' professional experience providing direct services or supervision of services such as case management and / or mental health services, crisis residential, transitional residential treatment, or day rehabilitation to a client population of adults or children with psychiatric challenges. Experience should include documentation responsibility and a demonstrated familiarity with Medi-Cal rules and regulations. Excellent computer skills related to Microsoft Office (Word, PowerPoint, Excel). Must have knowledge of electronic health / medical records systems, i.e., preferably Avatar.

Preferred : Be familiar with ICD-10 and DSM-5 diagnostic criteria. Strong interpersonal skills and oral / written communication skills. Strong public speaking skills and comfortable speaking and training in 1 : 1 and group settings. Ability to deal effectively with diverse individuals and personality types, regardless of ethnicity, race, gender identity, religious background, or socio-economic level.Knowledge of working with private insurance companies and experience coordinating services, including insurance verification, managing client share of cost, and collaborating with various programs to ensure the delivery of appropriate care.

Driver's license for at least two years and driving record acceptable to insurance carrier.

Valid California driver's license; auto in safe operating condition; auto liability insurance; good driving record; criminal record clearance; proof of authorization to work in the United States as required by Immigration and Reform Act of 1986. Ability to work independently with minimal supervision.

ESSENTIAL DUTIES AND RESPONSIBILITIES

Under the supervision of the Quality Assurance Supervisor, the Quality Assurance Specialist I, will perform and assist with the following duties :

Liaison and Client Communication :

Training and Development :

Program Support :

Accreditation & Quality Assurance :

Compliance & Audits :

PHYSICAL REQUIREMENTS

Ability to : operate a motor vehicle; climb stairs; possess good communication skills; meet the requirements of the classification and have mobility, vision, hearing and dexterity levels appropriate to the duties to be performed. See well enough to read data on a computer screen and text in written documents; perform extensive computer keyboard operations. Capable of the following extended activities : walking, standing, sitting, climbing stairs. Capable of the following intermittent activities : stooping, kneeling, lifting 25 pounds or more and bending in the performance of infrequently performed office duties.

This job description is intended to have an accurate reflection of the qualifications and job duties; current management reserves the right to revise the job at any given time when circumstances change. This job description replaces all previous description for this position.

Interim, Inc. is an equal opportunity employer.

Interim Inc. is guided by the precept that in no aspect of its programs, services or employment practices shall discrimination be permitted because of race, color, national origin, gender, age, creed, religion, physical or mental disability, marital status, medical condition, pregnancy, childbirth, or related medical condition, citizen status, veteran status, military status, sexual orientation, gender identity, or other characteristic protected by state or federal law. To comply with the Americans with Disabilities Act and other applicable laws ensuring equal employment opportunities to qualified individuals with a disability, reasonable accommodations are made for the known physical or mental limitations of an otherwise qualified individual with a disability, unless hardship, direct threat to health or safety, or other job-related consideration exists. Individuals who feel that they have been unlawfully discriminated against because of membership in one of the protected classes should contact the following : Director of Human Resources, Interim, Inc., PO Box 3222, Monterey, CA 93942. (831) 649-4522.