Position Summary:
Person in this position will be responsible for assisting the agency in ensuring that documentation requirements for Medicaid, Medicare and other funding sources per chapter and contract guidelines are adhered to. Responsibilities include but are not limited to: clinical records review, medical records, and interdepartmental communication. Essential Job Functions include:
Essential Job Functions:
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Possess and/or develop expertise in the areas of quality documentation and records review in relation to Medicaid/Medicare regulations and all other federal, state and local rules and regulations that apply to WestCare Arizona’s specific programs.
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Develop and/or utilize existing monitoring tools, forms, processes and implement systems for compliance in all programs which will ensure that the programs and individuals meet documentation requirements and clinical records through monitoring.
- Conduct quality assurance site-based reviews of client files
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Possess and/or develop expert proficiency in WestCare Arizona’s electronic health record; in the client file, service manager, and reporting features.
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Attend staff meetings, training and in-service as assigned by supervisor and/or as required by the agency;
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Develop concise and timely reports, including reports by program regarding client file reviews, as necessary and distribute reports to the management team on a defined basis
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Handle CARF Service Claims Audit reports quarterly including facility reports to Billing Supervisor.
- Supervise front desk personnel
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Conduct supportive administrative assistant-type duties as needed
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Embrace and embody the mission, vision, guiding principles, clinical vision and goals of WestCare Foundation; and
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Perform all other duties as assigned.
Essential Qualifications:
Certifications/Licenses:
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Ability to obtain level I fingerprint clearance card, pass central registry background check
Education:
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Bachelor’s degree from accredited institution with previous demonstrated QA experience in behavioral health field preferred; or
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Education and and a minimum of 2 years’ experience with QA
Experience and Competencies:
- Experience working with a substance abuse/mental health population is preferred;
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Excellent language and interpersonal skills;
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Knowledge of HIPAA regulations and guidelines;
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Superior organizational skills and attention to detail; and
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Strong computer skills, to encompass all Microsoft Office Platform Applications
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Knowledge of electronic record keeping systems
