Quality Assurance Specialist

The Quality Assurance Specialist (QAS) assures that clinical documentation meets county and state standards. The QAS is responsible for medical records review and quality assurance/utilization review, audit preparation, intake assistance, and serves as a resource for clinical staff around charting, billing, and eligibility. QAS also provides general support for all programs as needed.  

Key Responsibilities:

• Provides detail-focused review of clinical documentation to ensure quality, regulatory compliance, and audit-readiness  
• Tracks all aspects of the MediCal process including but not limited to: monthly MediCal eligibility monitoring, setting up MediCal files, coordinating and monitoring dates for quality assurance reviews, and monitoring the thorough completion of all client documentation (e.g., signatures, co-signatures, dates, etc.)
• Provides support to clinicians around documentation, charting, and billing procedures
• Provides administrative assistance to the clinical intake process
• Assists in utilization review and research programs 
• Provides general administrative support such as answering and directing calls, assisting clients, and other support tasks
• Creates, maintains, and updates client’s electronic records, charts, and file room
• Additional duties as requested by the Associate Director of QA and Compliance

Qualifications:

• College degree preferred, and/or related administrative experience in healthcare or human services organizations
• Previous experience with MediCal or managed care documentation, billing, and audits preferred
• Clean California DMV and insurance; local travel and car required (position may require driving between Oakland office and Hayward site)

Competencies (Skills, Abilities, and Knowledge):

• Ability to work independently and collaboratively as part of a multidisciplinary team 
• Ability to work within an intensive clinical setting
• Ability to prioritize projects appropriately and attend to details.  Efficiency and thoroughness is required
• Knowledge of issues of race, class, and ethnicity 
• Experience working with diverse communities
• Proven understanding of client confidentiality and HIPAA
• Working knowledge of MediCal eligibility, reimbursement, and billing 
• Excellent client and staff relation skills
• Excellent interpersonal, communication, and writing skills
• Excellent organizational and computer skills, as well as spoken and written communication skills
• Knowledge of MS Office Suite including Excel, PowerPoint, Google Calendar, and Google Mail on a Mac OS platform
• Bilingual Spanish language skills preferred (bilingual candidates are encouraged to apply)

This is a full-time, hourly position. Starting rate is $24.00 hourly, with 10% language differential (if applicable), and includes competitive benefits and compensation package, 403b and performance-based compensation plans.

-Be part of a compassionate, driven team that is social justice-focused: We have Staff Affinity Groups such as Staff of Color, LGBTQ+, Equity and Inclusion, Health and Wellness, and more!

-Make a difference for the Bay Area’s most vulnerable populations: We serve hundreds of vulnerable kids and their families each year to create positive changes in their lives!

-Access a growth-oriented learning community: As a Joint Commission Accredited agency, we are dedicated to providing the highest standard of care, and offer extensive clinical trainings and seminars led by field experts. 

• Annual incentive compensation and retirement plan contribution
• 100% Employer paid medical (base plan, Kaiser HMO), dental, vision, life insurance, and long-term disability coverage for full-time employees
• Variety of medical plan options including a variety of carriers and types of plans
• 403b retirement plan with ROTH and 403b contribution options
• Flex-spending options - Medical, Dependent Care and Commuter Plans
• 20 days paid time off per year (equivalent to 4 weeks), 14 Paid Holidays, plus Self-Care Leave (additional PTO accrual with increased years of service)