Compliance, QA Specialist

This is a fully remote position, open to applicants in South Africa.

📋 Description

• Establish employee and provider profiles within the company’s systems.

• Utilize AI tools to pinpoint session notes that may not align with funder expectations and assess flagged concerns.

• Perform documentation audits in accordance with approved standards and procedures.

• Examine RBT and BCBA notes for absent goals, incomplete or overly similar narratives, signature discrepancies, and erroneous dates or times.

• Cross-check documentation with CentralReach billing, service records, and schedules to identify any discrepancies.

• Coordinate with providers to rectify issues and follow up on pending amendments.

• Ensure an accurate audit trail is maintained within assigned permissions.

• Keep Excel trackers updated for new-RBT reviews, recurring errors, amended or removed notes, and unresolved corrections.

• Review parent/caregiver training utilization, including service code 97156, against payer-specific requirements and follow up with BCBAs as necessary.

• Assist with administration of profiles, notes, and timesheets.

• Help with the testing of CentralReach mobile workflows and report any system issues.

• Train new employees on appropriate documentation practices and promote consistent documentation standards.

• Collaborate closely with RBTs, BCBAs, and other providers to accurately resolve documentation issues in a timely manner.

• Offer constructive feedback while maintaining a calm, objective, and professional demeanor during challenging interactions.

⛳️ Requirements

• Highly detail-oriented and meticulous.

• Exceptionally organized with strong follow-through abilities.

• Patient and at ease with repetitive documentation reviews.

• Quick learner who can independently comprehend and apply guidance.

• Confident in providing constructive feedback and following up on necessary corrections.

• Comfortable managing resistance or pushback without taking it personally.

• Skilled at accurately identifying inconsistencies, errors, and missing information.

• Strong written and professional communication skills with providers.

• Comfortable handling confidential records and sensitive information.

• Proficient in Excel and Microsoft Office Suite.

• Prior healthcare experience or experience with CentralReach is not mandatory; training will be provided.

• Background in healthcare, clinical administration, quality assurance, or documentation review is advantageous.

• Familiarity with clinical or medical records is a plus.

• Knowledge of ABA terminology or clinical documentation would be beneficial.

• Experience with CentralReach or similar healthcare/clinical systems is advantageous.

• Higher education in psychology, healthcare, medical, clinical, or a related field is advantageous.

• No specific clinical license or mandatory qualification is required.

• Proficient with Microsoft Excel, Word, SharePoint, Outlook, Teams, Zoom, CentralReach, and CentralReach mobile; training on CentralReach will be provided.

🏝️ Benefits

• Competitive salary and comprehensive benefits package.

• Opportunities for professional development and training.

• Supportive work environment fostering collaboration and growth.