QA Specialist

Responsible for monitoring, reviewing, and proposing measures to correct or improve staff capability and quality

Responsibilities

• Accountable for internal competency of Inpatient/Outpatient Coding staff

• Develop content for and deliver orientation and training for new associates and ongoing skill-based training for all reviewers

• Complete quality assurance processes; document and report findings

• Lead client and reviewer quality communication and resolution

• Test McBee Clinical Review functionality

• Act as an expert resource for highly complex or first-of-a-kind reviewer questions; ensure knowledge management resources are available, updated and leveraged.

• Accountable to communicate quality concerns to all stakeholders

Qualifications

Required

• At least 4 years of experience in Inpatient/Outpatient Coding review

• Expert in ICD-10 coding and guidelines

• Proficient in Inpatient/Outpatient industry regulations and guidelines

• Excellent communication and presentation skills

• Working knowledge of Microsoft Office

Preferred

• Advanced clinical degree

• Active clinical license (e.g. RN, PT, OT, SP)

Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all individuals. We celebrate diversity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.

Netsmart desires to provide a healthy and safe workplace and, as a government contractor, Netsmart is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to Netsmart policy, all post-offer candidates are required to successfully complete a pre-employment background check, including a drug screen, which is provided at Netsmart’s sole expense. In the event a candidate tests positive for a controlled substance, Netsmart will rescind the offer of employment unless the individual can provide proof of valid prescription to Netsmart’s third party screening provider.

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All applicants for employment must be legally authorized to work in the United States. Netsmart does not provide work visa sponsorship for this position.

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