Quality Assurance and Compliance Assistant

Overview:

ORGANIZATION: Allegheny Children’s Initiative
DEPARTMENT: Administration
POSITION: Quality Assurance and Compliance Assistant
STATUS: Full Time; 40 hours / week
SCHEDULE / HOURS: Monday through Friday; 9:00 AM to 5:00 PM
LOCATION: Pittsburgh (South Side)
SALARY / WAGES: $20 - $22/hr

Allegheny Children’s Initiative, a subsidiary of Partners For Quality Inc., is a non-profit organization that provides mental and behavioral health community-based services to children, adolescents and families throughout Allegheny County. Based in Pittsburgh’s South Side, we provide Intensive Behavioral Health Services, Service Coordination, Student Assistance, Parent-Child Interaction Therapy, and Family Based Mental Health programs. ACI has earned certification from the Council On Accreditation.

Responsibilities:

• Verify insurance coverage for all open consumers daily using EVS. Communicate any loss of coverage to appropriate program staff and/or program director(s).
• Submit insurance authorizations for consumers through Managed Care Organization, as appropriate, and ensure accurate entry of authorization information into consumer Electronic Health Record.
• Generate insurance authorization reports on a weekly basis to monitor and manage consumer authorizations for programs, as appropriate.
• Oversee record storage by organizing and placing records in storage, tracking their status, and ensuring the appropriate destruction of records when necessary.
• Oversee the records request process, ensuring that records requests to external parties are sent promptly, and incoming records requests, from external parties, are addressed in a timely manner.
• Promptly and accurately upload incoming documentation into the Electronic Health Record (EHR) system, ensuring proper categorization and tracking of specific documents for compliance and continuity of care.
• Oversee the distribution and upload of completed releases of information for active consumers.
• Collaborate with staff and families to ensure the timely completion of telehealth encounter forms and their subsequent upload to the Electronic Health Record.
• Complete and submit interpretation services invoices to fiscal within two business days of receipt.
• Assist programs with consumer discharges by ensuring that documentation and all appropriate paperwork is completed, documented, and disseminated as needed.
• Manage the FSS request process by collaborating with program leadership and fiscal department to secure funding for requested purchases.
• Serve as the primary point of contact for the Tickets for Kids program, managing communications and coordination between the organization and staff to ensure efficient ticket distribution and program participation
• Assist with the collection, tracking, and reporting of data as outlined in the agency’s Performance and Quality Improvement initiatives.
• Assist with the quarterly record review process by randomly selecting records for review, notifying program directors, and compiling the data once the reviews are completed.
• Collaborate with the fiscal department and program directors to address issues related to billable services.
• Ensure strict compliance with all personnel and departmental policies and procedures, regulatory requirements, payor requirements, and Council on Accreditation (COA) Standards.
• Perform additional duties as required by the Executive Director and/or Director of Quality Assurance and Compliance.

BENEFITS

• Full Time employees enjoy a comprehensive benefits package:
• Health, Dental and Vision Insurances
• $1,200 cash payout option in lieu of Health Insurance coverage
• Healthcare Flexible Spending Account
• Dependent Care Flexible Spending Account
• 16 to 26 Paid Days Off / year
• Wellness Days (2 per year)
• Sick Time
• 8 Paid Holidays
• Short Term Disability
• Long Term Disability
• Life Insurance
• Optional 401(k) with Employer match

WORK PERKS

• Paid orientation and training
• Free parking (select locations)
• Employee Activities, Rewards and Recognition Programs
• Comprehensive Employee Assistance Program

APPLY TO THIS POSITION

Interested applicants can choose to apply in any of the following ways:

Complete an employment application online

Email resumes:[email protected]

Partners For Quality and its family of agencies are an equal opportunity employer

EOE

Qualifications:

• Bachelor’s Degree
• Minimum of two (2) years administrative responsibilities in healthcare/behavioral health.
• Excellent communication skills
• Excellent computer skills
• Electronic Health Record experience
• Valid Driver’s License
• Use of personal vehicle required
• Act 33 / 34 and FBI clearances required

Minimum Compensation: USD $20.00/Hr. Maximum Compensation: USD $22.00/Hr.