Medicaid/Continuous Quality Improvement (CQI) Specialist
Sequel Youth and
Family Services of Tuskegee, a residential treatment program for male adolescents
with severe emotional and behavioral disorders, has an immediate opening for a
full-time Medicaid/CQI Clerk.
The Medicaid/CQI
Clerk ensures that all resident records meet standards of internal policies and
procedures, AL Department of Human Resources/AL Department of Youth Services as
to format and timeliness. Collects,
inputs, and files information to ensure accurate and timely completion of the
Medicaid billing process. Serves on Safety and Clinical Medical committees and
assists with the development, implementation, and compliance of all safety
programs and policies within the facility.
Duties Include:
·
Monitors resident charts and oversees the proper filing of resident
records.
·
Responsible for the storage and protection of resident records.
·
Communicates findings of resident record audits via memo and committee
meetings.
·
Reviews deficiencies noted on chart audits to ensure corrections have been
made.
·
Assists with Admissions/Intake. Tracks referrals and census data.
·
Collects supporting documentation from all departments indicating delivery
of billable services to participating clientele in the AL Medicaid Program.
·
Ensures accurate and timely input of information into the program's
Medicaid Billing Program.
·
Ensures billing information is forwarded to the Accounts Receivable
department on a monthly basis.
·
Maintains Medicaid documentation in accordance with program operating
procedures and policies as well as auditing entities for Medicaid.
·
Monitors the billing process to determine efficiency and effectiveness in
maximizing billing potential.
·
Coordinate with directors to track Risk Management: collect, review, and
correlate data of all risk incident reports.
·
Coordinate with directors to track Risk Management by assisting to maintain
documentation of all Incident Reports.
·
Generates monthly, quarterly, and annual Risk Management Reports and
reports findings to the appropriate Committee.
·
Coordinate with directors to track Risk Management by assisting with documentation
of the Performance Improvement and Outcomes Management activities for the
facility.
Qualifications:
·
High School Diploma or equivalent.
·
Familiarity with record keeping system in a psychiatric or residential
setting with direct involvement with records in such a facility.
·
Previous experience with children/adolescents ages 12-18 in the Mental
Health field is preferred.
·
Quality assurance/improvement process experience is preferred.
·
Must have exceptional verbal and written skills.
·
Must possess initiative and judgment capabilities to organize and plan
activities, systematize procedures, collect data, compile statistics, track and
trend identified problem areas, and compile meaningful reports.
·
Must be flexible to adjust to changing conditions and varied duties of the
position.
·
Ability to recognize and maintain confidentiality of resident records and
information.
·
Ability to interpret and comply with standards of AL Department of Human
Resources/Al Dept. of Youth Services.
·
Strong computer literacy including the ability to use various hardware and
software (word processing, etc.).
Benefits:
·
Medical, Dental, Vision, and Life Insurance after 30 days
·
Company provided Short Term and Long Term Disability
·
Company provided AD&D insurance
·
Flexible Spending program
·
401K after sixty days
·
6 paid holidays
·
18 days personal leave accrual within first year