Quality Assurance Specialist

The Quality Assurance Specialist (QAS) ensures that clinical documentation complies with county and state standards. The QAS oversees medical records review, quality assurance, utilization review, audit preparation, and provides intake support. Additionally, the QAS serves as a resource for clinical staff on charting, billing, and eligibility matters, and offers general support across all programs as needed. 

Key Responsibilities:

• Conducts detailed reviews of clinical documentation to ensure quality, compliance, and audit readiness.
• Manages the MediCal process, including eligibility monitoring, file setup, quality assurance review coordination, and documentation verification.
• Supports clinicians with documentation, charting, and billing.
• Assists with clinical intake and utilization review processes.
• Provides general administrative support, including call management and client assistance.
• Maintains and updates client electronic records, charts, and file organization.
• Performs additional duties as assigned by the Associate Director of QA and Compliance.

Qualifications:

• Must be able to work Monday through Friday during the hours of 9:00am-5:30pm
• Previous experience with MediCal or managed care documentation, billing, and audits preferred
• College degree preferred, and/or related administrative experience in healthcare or human services organizations
• Clean California DMV and insurance
  

Competencies (Skills, Abilities, and Knowledge):

• Capable of working well independently
• Strong project prioritization and attention to detail, with a focus on efficiency and thoroughness
• Awareness of race, gender, power, and privilege dynamics in community mental health
• Strong understanding of client confidentiality and HIPAA
• Excellent interpersonal, communication, and writing skills
• Proficient in organization, computer skills, and written/spoken communication
• Skilled in MS Office Suite, including Excel, PowerPoint, Google Calendar, and Google Mail on Mac OS
• Bilingual candidates encouraged to apply

Position Details and Compensation:

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.

Why work here?

-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. 

We also offer:

• 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
• 15 days paid time off per year (equivalent to 3 weeks), 11 Paid Holidays, plus Self-Care Leave (additional PTO accrual with increased years of service)
• Professional development stipend
• Monthly wellness stipend