Quality Assurance (QA) Review Specialist
Summary of Position:
The Quality Assurance (QA) Review Specialist - performs review functions to ensure that disclosures of PHI and PI are accurate and complete and comply with client protocols, state and federal privacy laws and regulations and/or with policies and procedures regarding HIPAA, PHI and PI. This position may be performed remotely.
Duties & Responsibilities:
- Reviews authorizations and requests for records to ensure that all pertinent information is contained on these forms and the dates are valid and relevant to the release process.
- Verifies that the attached medical records correlate to the authorization and request and documentation encompasses that patient only.
- Follows all Quality Assurance policies, procedures and job aids.
- Proactively communicates with Manager or Supervisor regarding further clarification and when additional work is needed.
- Actively participates with QA Team Meeting discussions.
- Sends notifications to requestor when applicable
- Communicates with company personnel in a professional and friendly manner
- Communicates with Release of Information Specialists and Client Site Managers on issues pertaining to quality review.
- Attends and completes on time, all required training sessions provided by Verisma
- Meets accuracy standards and performance indicators established by the Company
- Performs other appropriate duties as assigned to meet the needs of the department and the Company
- Consistently live by and promote Verisma Core Values
- Must be detail oriented
- HS Diploma or equivalent, additional education in Health Information is preferred
- Knowledge and ability to use components of Microsoft Office Suite to complete tasks and possess the ability to learn new software applications
- 2 years’ experience in a professional office environment or healthcare setting, preferred with medical terminology knowledge
- Knowledge of HIPAA and state regulations related to the release of Protected Health Information, preferred
- Must be able to communicate clearly and concisely to relay information to other departments
- Must be able to work independently