Quality Assurance Specialist Summary Title:Quality Assurance Specialist ID:0307-4693 Department Location:Health Center at International Circle, 2828 International Circle, , Colorado Springs, CO 80910 Category:Administrative / Clerical / Skill Trades Description Peak Vista Community Health Centers is a nonprofit health care organization whose mission is to provide exceptional health care to people facing access barriers through clinical programs and education. We provide integrated health care services including medical, dental, and behavioral health through our 22 outpatient health centers. We deliver care with our strong "Hospitality" culture. Our organization has over 800 employees and serves more than 81,500 patients annually in the Pikes Peak and East Central regions of Colorado. Our service area covers 14 counties, from the front range to the Kansas border, with locations throughout Colorado Springs, Fountain, Flagler, Divide, Limon, and Strasburg. Peak Vista is accredited by the Accreditation Association for Ambulatory Health Care, Inc. (AAAHC). Compensation (Pay): $17.50 to $25.38/hourly, based on experience. Summary of Benefits: • Medical, Dental, Vision, Life, STD, LTD • 403(b) Retirement with Company Match • Paid Time Off • Tuition Assistance • Perks Rewards • Employee Assistance Program https://www.peakvista.org/resources/benefits-summary Job Summary: The Quality Assurance (QA) Specialist plays a crucial role in ensuring that the Peak Vista Community Health Centers (PVCHC) Enrollment Services Department maintains a high standard of quality. This role is tasked with ongoing maintenance and quality assurance to ensure compliance with all state guidelines and requirements, as well as those set by other programs. The QA Specialist is tasked with the development and implementation of guidelines and rules for both PVCHC and outside programs. They provide essential administrative support for all Enrollment Services operations and designated staff, as needed. Their responsibilities include executing routine administrative tasks that support patient care and revenue cycle operations. Demonstrates a strong commitment to excellent customer service; they facilitate patient-centered care while strictly following all Peak Vista policies, regulatory requirements, and accreditation standards. Essential Duties and Responsibilities: + Determines eligibility for SFS applications, verify private insurance, CHP+ and Medicaid through Webportal. + Registers patients who currently have private insurance, Medicaid, and/or CHP+ and ensures all paperwork/eligibility is efficiently reviewed with each patient. + Inputs data into practice management systems meticulously. + Auditing and reporting will focus on closely monitoring and offering constructive feedback to our staff, ensuring that the quality of customer service for both incoming and outgoing calls meets or exceeds standards. + Auditing may include auditing and reporting for various applications and processes within the department. + Provides direct support for Enrollment Services operations pertinent to efficient ambulatory patient care; responsibilities allocated as applicable and within operational requirements. + Assists in the reconciliation of day-to-day application intake, to assure collection of date is not misplaced. + Promotes and participates in the development of Enrollment Service Specialists to ensure all delivery platforms support a patient-centric approach. + Precepts new staff, as required. + Serves as the liaison between designated support staff and leadership. + Ensures all applicable forms are updated and utilized, accurately capturing patient information for billing and compliance purposes. + Assists with exceptional service, service recovery, and creates a positive patient experience, focusing on first-time resolution. + Ensures accountabilities for all programs rules and requirements aligned with department reconciliation + Possesses interpersonal and professional communication skills and abilities in conjunction with emotional intelligence + Floats to other Enrollment Services locations to support front line staff. Travel is required to meet the needs of the organization. + Answers calls regarding patient coverage status, payer contract and billing questions, transferring calls to appropriate departments and other patient service duties. + Make appointments for enrollment and clinics. + Supports various internal departments by providing quality customer service. + Contributes to a culture of kindness. + Adheres to assigned schedules. + Displays a willingness to learn. + Adapts to departmental and organizational changes. + Displays a strong attention to detail. + Promotes and demonstrates the mission, vision, and Core Values of Peak Vista. + Develops and maintains good working relationships with all departments, the management team, medical staff, and leadership. + Embraces cultural diversity amongst ourselves and our community. + Responsible for the human, financial, and material resources as well as data and information entrusted to us. + Strives to deliver the best outcomes and highest quality service. + Demonstrates knowledge of and adherence to the Compliance Plan and conflict of interest requirements. + Enhances the effectiveness, efficiency and productivity of the department by contributing to, and participating in, departmental performance improvement goals. + Performs other duties, as assigned. Supervision Exercised: None Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Spanish bilingual preferred. Education/Experience: Education: High school diploma or equivalent education. Work Experience: One-year customer service experience in healthcare setting required. Computer Skills: Basic – ability to access the intra/internet to manage timecard, review policies and procedures, and read company communications; use e-mail to communicate with co-workers, leadership, and other departments; enter and correct data, modify a workbook, format a worksheet, and use printing functions; create a simple presentation in PowerPoint, run it, and print it Certificates and Licenses: None Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. OSHA risk level/work environmental hazards: This position has been categorized as OSHA Level Two. See Exposure Control Plan for details. The noise level in the work environment is usually quiet. Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The employee must occasionally lift and/or move up to 20 pounds. While performing the duties of this job, the employee is frequently required to sit. The employee is occasionally required to stand and walk. *Successful candidates will complete pre-employment screening; which includes, but is not limited to a Criminal Background check. Peak Vista Community Health Centers is a drug and alcohol free workplace an an Equal Opportunity Employer. **PVCHC participates in the Electronic Employment Verification Program. E-Verify is an Internet-based system that compares information from an employee’s I-9 to data from the U.S. Department of Homeland Security and Social Security Administration Records. 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