Quality Assurance Specialist

Job Summary

Ensuring the accuracy and compliance of Medicare and Medicaid claims, the full-time Quality Assurance Specialist will perform detailed reviews of patient care reports, validate documentation, and confirm adherence to regulatory requirements in a remote setting.

Key responsibilities

• Conduct thorough quality reviews of Medicare/Medicaid claims post-coding to ensure accuracy and compliance
• Examine patient care reports to verify documentation supports billed services and meets payer standards
• Collaborate with internal teams to address documentation issues and support continuous quality improvement initiatives

Required qualifications

• High School Diploma or equivalent required; clinical or medical background preferred (LPN, RN, EMT, etc.)
• Strong understanding of medical terminology, EMS clinical documentation, and healthcare billing standards
• Ability to efficiently navigate multiple computer programs simultaneously
• Reliable home internet with speeds of 15 Mbps or higher
• Excellent attention to detail and strong time management skills in a remote work environment