Consumer Loan Quality Assurance Representative jobs in Harlingen, TX

Job Summary

QUALITY ASSURANCE

• Works with Billing Department/Office Manager on the undropped list to ensure that documentation supports claim for payment.
• Gives appropriate feedback to staff on individual basis at least weekly in an effort to maintain standards on documentation.
• Informs Supervisor and nursing supervisory staff on a regular basis of problem areas in terms of documentation.
• Participates in weekly case conferences and shares Recert audit findings with staff
• Audits charts for Medicare denials and ADR’s prior to submitting chart to Supervisor.
• Reviews charts for quality of care rendered; i.e. orders followed, appropriate utilization of visits, appropriate contacts with physician and other disciplines. Will be rated by supervisor based on findings.
• Reviews SOC’s, Recerts, ROC’s as soon as received from Coders. Distributes packets to appropriate RN for signatures and corrections.
• Reviews packets received from RN to confirm signatures, dates and corrections were completed and removes all stickies’ before sending to Medical Records.
• Reviews all discharged charts for completeness before Discharge summary is sent to MD within 48 hours of discharge.
• Obtains the Monthly Recert List from Data, to schedule chart audits
• Schedules chart audits 2 weeks before RN will do Recert, using Recert Audit Form
• Completes the Recert Audit form by auditing the entire chart and places form in the RN Recert packet.
• Audits daily notes for proper documentation and timely notification to field staff
• Audits Med updates for completion; telephone orders for contents and frequency verification.
• For all visit increases, an Additional Visit Request Form will be completed and faxed to Administrator for approval before visits are done. Audits for abbreviations on the “Do not Use Abbreviations” list.
• Audits therapy notes for specific orders for treatment “NOT” “modalities as needed”
• Follows up with new employees on proper documentation and timely submittal of paperwork and informs Orientation Department of further training required.
• Follows up on corrections by using the Deficiency forms after signed and submitted by staff
• Submits a Daily QA report to Supervisor for DOPS/Administrator production review.

OTHER DUTIES

• Continually strives to improve knowledge within their field.
• Functions as a staff nurse at the direction of the Director of Professional Services when the need arises.
• Collects and files in specified Binders all Hospitalizations, Infections, Incidents and falls
• Maintains Lab log for all lab documentation especially PT/INR, and Dilantin Level and MD follow-up.

Job Type: Full-time

Pay: $15.00 - $22.00 per hour

Standard shift:

• Day shift

Supplemental schedule:

• On call

Weekly schedule:

• Monday to Friday
• Rotating weekends

Ability to Relocate:

• Harlingen, TX 78550: Relocate before starting work (Required)

Work Location: In person