quality assurance specialist

Zenith Behavioral Health

<div><h1 class="jobSectionHeader">ERG II LLC</h1><h2 class="jobSectionHeader">
Job Description - Quality Assurance Specialist</h2><h3 class="jobSectionHeader">
Position Title:</h3>
Quality Assurance Specialist<h3 class="jobSectionHeader">
Employment Status:</h3>
Full-Time<h3 class="jobSectionHeader">
Work Location:</h3>
Primarily Remote Position
This position is primarily remote; however, occasional travel may be required during the onboarding process and throughout employment to assist with staff training, quality assurance reviews, audits, and operational support.<h2 class="jobSectionHeader">
Position Summary</h2>
The Quality Assurance Specialist works collaboratively with the Director of Quality Assurance, Vice President of Compliance and Operations, Utilization Review Department, Clinical Leadership, and Program Staff to ensure clinical and operational compliance across all programs. Responsibilities include program development and implementation, extensive quantitative and qualitative chart auditing, training staff on medical necessity and documentation standards, maintenance of policies and procedures, verification of billing documentation, and ensuring compliance with all applicable state, federal, accreditation, and regulatory requirements.
The Quality Assurance Specialist plays a critical role in maintaining the integrity of client records, ensuring accurate documentation, supporting revenue cycle processes, and promoting compliance with organizational standards and regulatory requirements.<h2 class="jobSectionHeader">
Essential Job Responsibilities</h2><h3 class="jobSectionHeader">
Clinical DocumentationChart Auditing</h3><ul><li>
Conduct comprehensive qualitative and quantitative chart audits to ensure compliance with organizational, payer, and regulatory requirements.</li><li>
Audit clinical documentation to verify accuracy, completeness, timeliness, and compliance.</li><li>
Monitor client charts daily to ensure all documentation supports the appropriate level of care and medical necessity.</li><li>
Follow up with staff regarding deficiencies identified during audits and ensure corrective actions are completed within established timeframes.</li><li>
Maintain audit records, corrective action plans, and compliance reports.</li></ul><h3 class="jobSectionHeader">
ComplianceQuality Assurance</h3><ul><li>
Develop, implement, and maintain quality assurance systems and checks-and-balances tools to ensure chart compliance.</li><li>
Ensure services provided comply with:<ul><li>
HIPAA regulations</li><li>
42 CFR Part 2 requirements</li><li>
Joint Commission standards</li><li>
CARF standards</li><li>
ADP requirements</li><li>
State and Federal regulations</li><li>
Insurance and payer documentation requirements</li></ul></li><li>
Assist with policy and procedure development, review, and maintenance.</li><li>
Identify compliance risks and recommend corrective actions and process improvements.</li></ul><h3 class="jobSectionHeader">
TrainingStaff Development</h3><ul><li>
Assist with training and education of Clinical and Support Staff regarding:<ul><li>
Medical necessity documentation</li><li>
Clinical documentation requirements</li><li>
Regulatory compliance standards</li><li>
Quality assurance processes</li></ul></li><li>
Collaborate with Clinical Directors and Leadership Teams to provide coaching and documentation support.</li><li>
Participate in onboarding and ongoing staff education initiatives as assigned.</li></ul><h3 class="jobSectionHeader">
Utilization ReviewBilling Support</h3><ul><li>
Collaborate with the Utilization Review Department to ensure timely completion of clinical documentation.</li><li>
Work with billing departments and contracted billing companies to verify documentation required for claims submission.</li><li>
Ensure documentation supports services billed and complies with payer requirements.</li><li>
Assist in resolving documentation-related billing issues.</li></ul><h3 class="jobSectionHeader">
Additional Duties</h3><ul><li>
Participate in program development and quality improvement initiatives.</li><li>
Assist with regulatory audits, accreditation surveys, and compliance reviews.</li><li>
Prepare reports and compliance metrics as requested.</li><li>
Perform other duties as assigned by the Director of Quality Assurance, Vice President of Compliance and Operations, Clinical Director, or Executive Leadership.</li></ul><h2 class="jobSectionHeader">
Required SkillsQualifications</h2><h3 class="jobSectionHeader">
EducationExperience</h3><ul><li>
Experience in behavioral health, substance use disorder treatment, mental health services, quality assurance, utilization review, or compliance preferred.</li></ul><h3 class="jobSectionHeader">
KnowledgeCompetencies</h3><ul><li>
Advanced knowledge of the 12-Step treatment model and its application in residential treatment settings.</li><li>
Knowledge of process addictions and available treatment resources.</li><li>
Understanding of dual-diagnosis treatment practices and non-pharmacological symptom management techniques.</li><li>
Advanced knowledge of HIPAA and 42 CFR Part 2 regulations.</li><li>
Knowledge of medical necessity requirements and clinical documentation standards.</li><li>
Familiarity with Joint Commission, CARF, and other accreditation standards.</li><li>
Strong analytical, organizational, and problem-solving skills.</li><li>
Excellent written and verbal communication skills.</li><li>
Ability to work independently while maintaining collaboration with multidisciplinary teams.</li><li>
Proficiency in electronic health record systems and Microsoft Office applications.</li></ul><h3 class="jobSectionHeader">
CertificationsRequirements</h3><ul><li>
Current First Aid/CPR Certification.</li><li>
Health Screening Clearance.</li><li>
Ability to travel occasionally as required.</li></ul><h2 class="jobSectionHeader">
Position Relationships</h2>
Supervised By: 
Director of Quality Assurance
Promotion From: 
N/A
Workers Supervised: 
N/A<h2 class="jobSectionHeader">
Performance Expectations</h2>
The employee will receive periodic performance evaluations measuring quality, productivity, compliance, communication, teamwork, and overall job performance.
Failure to meet performance expectations may result in the implementation of a Performance Improvement Plan (PIP) with specific goals and timelines for improvement. Continued failure to meet performance expectations may result in progressive disciplinary action, up to and including termination of employment.<h2 class="jobSectionHeader">
Equal Employment Opportunity Statement</h2>
ERG II LLC is committed to providing Equal Employment Opportunities to all employees and applicants. Employment decisions are made without regard to race, color, religion, sex, gender identity, sexual orientation, national origin, age, disability, veteran status, or any other protected characteristic under applicable federal, state, or local laws.<h2 class="jobSectionHeader">
Acknowledgment</h2>
I have read my position description and it has been explained to me by my supervisor. I understand my job functions and responsibilities and agree to perform all duties as outlined herein and any additional duties assigned by management. 
Employee Name: _____________________________________
Date: _______________________ 
Employee Signature: _____________________________________
Date: _______________________</div>

Quality Assurance Specialist

Master Works

<div>
 Master Works is seeking a
 
 Quality Assurance Specialist
 
 experienced in software testing and defect management. The role involves executing manual and automated tests, identifying and tracking defects, and working with development teams to ensure high-quality software delivery in an Agile environment.
 
 
 
 Key Responsibilities
 
 
 
 <ul>
 <li>
 Develop test plans, test cases, and comprehensive testing strategies for software applications
 </li>
 <li>
 Prepare, configure, and maintain testing environments to ensure readiness for all test cycles
 </li>
 <li>
 Execute manual and automated tests and accurately document all test results
 </li>
 <li>
 Identify, log, and track defects discovered during testing phases
 </li>
 <li>
 Collaborate closely with developers to ensure effective defect resolution and re-testing
 </li>
 <li>
 Lead and perform comprehensive test coverage activities to maximize efficiency and quality
 </li>
 <li>
 Validate applied fixes and conduct regression testing to ensure no new defects are introduced and that existing functionalities remain stable
 </li>
 <li>
 Review business and technical requirements to ensure completeness, testability, and alignment with quality standards
 </li>
 <li>
 Monitor software quality metrics and provide recommendations for continuous improvement
 </li>
 <li>
 Support release activities by performing final quality verification and sign-off procedures
 </li>
 <li>
 Mentor junior QA team members and promote quality assurance best practices across projects
 </li>
 <li>
 Participate in Agile ceremonies, including sprint planning, reviews, and retrospectives
 </li>
 <li>
 Ensure compliance with organizational quality standards, policies, and software development methodologies
 
 
 </li>
 </ul>
 
 Requirements
 
 
 
 
 Qualifications
 
 
 
 <ul>
 <li>
 Bachelor's degree in Computer Science, Software Engineering, Information Technology, or a related field
 </li>
 <li>
 Minimum 2+ years of experience in Software Quality Assurance and Testing
 </li>
 <li>
 Strong experience in manual and automated testing methodologies
 </li>
 <li>
 Hands-on experience with test management and defect tracking tools (e.g., Jira, Azure DevOps, TestRail)
 </li>
 <li>
 Experience with test automation frameworks and tools
 </li>
 <li>
 Strong analytical, problem-solving, and communication skills
 </li>
 <li>
 Knowledge of Agile/Scrum software development practices
 
 
 </li>
 </ul>
 
 Preferred Certifications
 
 
 
 <ul>
 <li>
 ISTQB Certified Tester (Foundation Level or Advanced Level)
 </li>
 <li>
 Certified Software Quality Engineer (CSQE) or equivalent certifications
 
 
 </li>
 </ul>
 
 Job location:
 
 Client Site.
</div>

Quality Assurance, Specialist

Pediatric Associates Family of Companies

<div><div><div>PRIMARY FUNCTION 

The Quality Assurance (QA) Specialist is responsible for evaluating the quality, accuracy, and effectiveness of patient interactions across the Patient Contact Center (PCC). This role conducts structured quality monitoring of calls and digital interactions to ensure adherence to clinical protocols, operational workflows, regulatory requirements, and organizational standards. 

The QA Specialist analyzes performance data to identify trends, root causes, and opportunities to improve First Call Resolution (FCR), Customer Satisfaction (CSAT), and access to care. 

The QA Specialist partners closely with Operations, Training, Workforce Management (WFM), and Leadership to identify performance gaps, deliver actionable insights, and support continuous improvement initiatives that enhance access, accuracy, and overall service delivery. 

ESSENTIAL DUTIES AND RESPONSIBILITIES
This list may not include all the duties that may be assigned. 

Quality Monitoring &amp; Evaluation
<ul><li>Conduct structured evaluations of inbound and outbound calls, chats, and other patient interactions to assess:
</li></ul><ul><li>Accuracy and completeness of information provided
</li></ul><ul><li>Adherence to scripts, workflows, and clinical protocols
</li></ul><ul><li>Compliance with company policies, regulatory requirements, and payer guidelines
</li></ul><ul><li>Effectiveness in resolving patient needs (FCR)
</li></ul><ul><li>Empathy, professionalism, and communication quality
</li></ul><ul><li>Complete a minimum number of evaluations per agent per month as defined by leadership
</li></ul><ul><li>Utilize standardized QA scorecards aligned to PCC priorities (Access, Scheduling Accuracy, Clinical Triage, etc.)
</li></ul>Performance Tracking &amp; Reporting
<ul><li>Compile, track, and maintain QA scores at the agent, team, and enterprise levels
</li></ul><ul><li>Assist with the Identification of trends, root causes, and performance gaps across:
</li></ul><ul><li>Call types (appointments, referrals, billing, clinical advice)
</li></ul><ul><li>Regions, skills, and programs
</li></ul><ul><li>Develop and distribute weekly and monthly QA performance reports, including insights tied to:
</li></ul><ul><li>CSAT drivers
</li></ul><ul><li>FCR opportunities
</li></ul><ul><li>Access and availability compliance 
</li></ul>Calibration &amp; Quality Governance
<ul><li>Participate in weekly calibration sessions to ensure scoring consistency across:
</li></ul><ul><li>Internal QA team
</li></ul><ul><li>BPO partners (e.g., Philippines) 
</li></ul>Confidentiality and Compliance
<ul><li>Maintain strict confidentiality of all patient, employee, and organizational information in accordance with HIPAA regulations and company policies
</li></ul><ul><li>Safeguard all Protected Health Information (PHI), ensuring it is accessed, used, and disclosed only as appropriate and authorized
</li></ul><ul><li>Protect the confidentiality of call recordings, call interactions, and any related documentation
</li></ul><ul><li>Maintain confidentiality of agent performance data, quality evaluations, and performance outcomes
</li></ul><ul><li>Complete all required HIPAA and compliance training and consistently apply learned standards in daily responsibilities 
</li></ul>SUPERVISORY RESPONSIBILITIES 

None. 

QUALIFICATIONS 

EDUCATION: High Scholl Diploma/GED or equivalent required. Bachelor&rsquo;s degree in business, Healthcare Administration, or related field preferred 

EXPERIENCE 

<ul><li>Minimum 3 years of call center or customer service experience required
</li></ul><ul><li>Minimum 2 years of quality assurance or quality monitoring experience preferred
</li></ul><ul><li>Experience working with regulated environments (e.g., healthcare compliance standards) preferred 
</li></ul>KNOWLEDGE, SKILLS, AND ABILITIES
<ul><li>Demonstrated ability to review and interpret quality and performance data to identify trends, patterns, and areas for improvement
</li></ul><ul><li>Understanding of quality calibration methodology and scoring consistency practices
</li></ul><ul><li>Familiarity with automated call distribution (ACD), IVR, and skill-based routing systems
</li></ul><ul><li>Experience with EHR systems and cloud-based contact center platforms (e.g., Talkdesk) preferred
</li></ul><ul><li>Excellent verbal, written, and interpersonal communication skills
</li></ul><ul><li>Strong attention to detail, accuracy, and timeliness
</li></ul><ul><li>Ability to work collaboratively in a team-oriented environment
</li></ul>TYPICAL WORKING CONDITIONS
<ul><li>Non-patient facing
</li></ul><ul><li>Hybrid/telework
</li></ul><ul><li>If remote, this job must be U.S. based.
</li></ul><ul><li>% travel required if any &ndash; 0% 
</li></ul>OTHER PHYSICAL REQUIREMENTS
<ul><li>Vision
</li></ul><ul><li>Sense of sound
</li></ul><ul><li>Sense of touch
</li></ul><ul><li>Work may require sitting for long periods of time
</li></ul><ul><li>Manual dexterity sufficient to operate a keyboard
</li></ul><ul><li>Long periods of time in front of a computer screen 
</li></ul>PERFORMANCE REQUIREMENTS
Adhere to all organizational information security policies and protect all sensitive information including but not limited to ePHI and PHI (Protected Health Information) in accordance with organizational policy, Federal, State, and local regulations.
The foregoing description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts or working conditions associated with the job. It is intended to be an accurate reflection of the general nature of level of the job.</div> 
</div> 
Location: Pediatric Associates &middot; Patient Contact Center 
Schedule: Full Time, Remote</div>

Absolute Business Solutions Corp. (ABSc)

<div>Absolute Business Solutions Corp (ABSC) is not just another tech company. We&rsquo;re a community of innovators, engineers, analysts and business professionals working together with our customers to tackle the most complex challenges. For more than 20 years we&rsquo;ve supported critical Department of Defense (DoD), Intelligence Community (IC), Federal Civilian missions and global, multi-national corporations. We specialize in supporting our clients in the Intelligence, Technology, Defense, AI/ML, and Data Science fields. As we continue to grow at a rapid pace, we need some amazing new professionals to join our team. In particular, we are seeking an experienced Quality Assurance Specialist to primarily support our program.
Seniority of this role: Junior
Clearance Required for this role: TS/SCI
Requirements:
<ul><li>Minimum 3 years of experience conducting analysis relevant to the specific labor category, with at least a portion of the experience within the last 2 years.
</li><li>Strong experience with Microsoft Word, PowerPoint and Excel.
</li><li>Bachelor&rsquo;s degree in an area related to the labor category from a college or university accredited by an agency recognized by the U.S. Department of Education. An additional 4 years of experience in the specific labor category, for a total of 7 years of experience in the specific labor category, may be substituted for a bachelor&rsquo;s degree.
</li></ul>Responsibilities:
<ul><li>Ensures that products, services, or software meet established quality standards and regulatory expectation</li>
</ul>
Who we are:
 
ABSC is a technology and services company that combines the agility of a small business with proven processes refined over more than two decades in business. We specialize in supporting public sector clients in the Intelligence, Defense, Health, and Safety areas. Our team stands ready to deliver the next generation of programs, personnel, and solutions to help advance our federal government customers&rsquo; driving innovation, agility, and security across all mission areas.
Some of our benefits include:
Generous PTO plus 11 Federal Holidays
Retirement Planning &ndash; 401k Fully Vested with Match
Annual Health and Wellness Allowance &ndash; buy an Apple Watch, a treadmill, or hit the gym on us
Career Development &ndash; Annual Funds to spend on Education, Training and AI Tools
Volunteer Time Off &ndash; Annually, all employees can spend 8 hours directly supporting a charity of choice
Charitable Match &ndash; ABSC matches an employee&rsquo;s donation to a qualifying charity
Referral Program &ndash; We pay for internal and external referrals!
LOV Awards &ndash; Earn bonus awards throughout the year from our Living Our Values awards program
Apply to join our team today! We are always looking to grow our team - if you know someone who is seeking a new career opportunity, please share this job opening with them! ABSC offers generous external referral bonuses. You don&rsquo;t need to be an employee to benefit from our Referral Program!
*ABSC is a proud V3, Virginia Values Vets, member which recognizes our commitment to hiring Veterans. If you are a veteran, please be sure to include that in your application. Thank you! *
Equal Opportunity Employer, including veterans and individuals with disabilities.</div>

DTE Energy Co

Quality Assurance Specialist (Remote) About DTE Energy Co DTE Energy (NYSE: DTE) is a Detroit-based diversified energy company involved in the development and management of energy-related businesses and services nationwide. Our operating units include an electric company serving 2.3 million customers and a natural gas company serving 1.4 million customers in Michigan. At DTE, we are dedicated to providing reliable and efficient energy solutions, with a portfolio that extends to industrial energy services, renewable natural gas, and energy marketing. We are looking for a meticulous and dedicated professional to join our team and contribute to our standard of excellence. Job Overview We are seeking a highly skilled Quality Assurance Specialist to join our team on a full-time, remote basis. The ideal candidate will be responsible for ensuring that our software systems and applications meet the highest standards of quality, reliability, and performance. You will play a crucial role in our development lifecycle, working closely with our technical teams to identify and resolve issues, thereby ensuring a seamless experience for our customers and internal users. This position offers a competitive hourly rate of $35 - $60 USD per hour. Key Responsibilities - Design, develop, and execute comprehensive test plans and test cases to ensure software quality. - Identify, record, and thoroughly document system defects, and track them to resolution. - Collaborate with software developers, project managers, and business analysts to understand requirements and resolve issues. - Perform thorough regression testing when bugs are resolved. - Conduct functional, non-functional, integration, and performance testing. - Analyse test results and prepare detailed reports for project stakeholders. - Contribute to the continuous improvement of our quality assurance processes and methodologies. - Ensure that final products meet business requirements and organisational standards before they are released. Qualifications - Proven experience working as a Quality Assurance Specialist, QA Engineer, or in a similar role. - Strong knowledge of software QA methodologies, tools, and processes. - Demonstrable experience in writing clear, concise, and comprehensive test plans and test cases. - Hands-on experience with both manual and automated testing tools. - Familiarity with Agile/Scrum development frameworks is highly desirable. - Excellent analytical and problem-solving skills with a keen eye for detail. - Strong verbal and written communication skills. - Ability to work independently and effectively in a remote team environment. - A degree in Computer Science, Engineering, or a related discipline, or equivalent professional experience. Benefits - Competitive hourly wage. - Opportunity to work fully remotely. - Be part of a leading and innovative company in the energy sector. - Professional development and career growth opportunities.

Quality Assurance Specialist (Remote)

Farm Bureau Financial Services

<div><div><div>**role will be filled at appropriate level based on experience**
Do you pay great attention to detail, and have strong organizational and time management skills? Are you a team player with a positive &ldquo;can-do&rdquo; attitude? If so, this Quality Assurance Specialist opportunity could be a great fit for you!
Who We Are: With Farm Bureau Financial Services, our client/members can feel confident knowing their family, business, home, cars and other property are protected. We value a culture where integrity, teamwork, passion, service, leadership, and accountability are at the heart of every decision we make and every action we take. We&rsquo;re proud of our more than 80-year commitment to protecting the livelihoods and futures of our client/members and creating an atmosphere where our employees thrive.
What You&rsquo;ll Do: As a Quality Assurance Specialist, you will review claim files to compare staff handling procedures to industry and company best practice guidelines and determine leakage within the claims process. You will also identify training needs, mentoring opportunities, process enhancements and employee performance evaluations needs that will impact coverage, loss ratio, and claims expenses.
What It Takes to Join Our Team:
<ul><li> College degree or equivalent plus at least five years&rsquo; underwriting or claims experience, or equivalent work experience required with a broad background in property casualty insurance.</li></ul>
<ul><li> AINS, AIC, API, or AU designation preferred.</li></ul>
<ul><li> Analytical, problem solving, decision-making and organizational skills required.</li></ul>
<ul><li> Must keep current with claims or underwriting technologies/systems.</li></ul>
<ul><li> Must keep up-to-date regarding legislation, statutes, rules/regulations, and case law for all eight states.</li></ul>
<ul><li> A valid driver&rsquo;s license and satisfactory Motor Vehicle Records are required.</li></ul>
<ul><li> Some travel is required (including overnight).</li></ul>
<ul><li> Oral and written communication skills as appropriate to this position.</li></ul>
<ul><li> Ability to read, write and speak the English language.</li></ul>
<ul><li> Training skills, attention to detail and the ability to meet target dates is required.</li></ul>
What We Offer You: When you&rsquo;re on our team, you get more than a great paycheck. You&rsquo;ll hear about career development and educational opportunities. We offer an enhanced 401K with a match, low cost health, dental, and vision benefits, and life and disability insurance options. We also offer paid time off, including holidays and volunteer time, and teams who know how to have fun. Add to that an onsite wellness facility with fitness classes and programs, a daycare center, a cafeteria, and for many positions, even consideration for a hybrid work arrangement. Farm Bureau....where the grass really IS greener!
If you're interested in joining a company that has a long history of stability, one that appreciates its employees, and offers great benefits, we invite you to apply today. Farm Bureau....where the grass really IS greener!</div></div></div>

Quality Assurance Specialist (Storm Claims)

Gemma Services (formerly Silver Springs Martin Luther School)

<div>QUALITY ASSURANCE FOR RAPID SERVICE RESPONSE PROGRAM IN PHILADELPHIA

The Quality Assurance staff is Responsible for quality assurance and data reporting for the Rapid Service Response Program (RSR) at Gemma Services, a brief home-visiting intervention. Duties include collaborating with program and fiscal staff to ensure compliance with reporting requirements, auditing charts, recommending workflow improvements, and managing the quality assurance plan. Must understand relevant local, county, state, and federal standards and internal policies for child welfare prevention programs.

Works with both internal departments and external partners to coordinate services, reports information to the RSR Director, responds to referrals and requests, and assigns cases after assessing referral details. Participates in case conferences to evaluate service suitability.

Oversees quality assurance and data reporting for RSR, including working closely with staff to maintain compliance, chart audits, workflow recommendations, and management of the QA plan, with thorough knowledge of regulations and internal policies.

 The Quality Assurance staff will:
<ul>
<li>Monitor DHS performance metrics; develop dashboards and tickler systems to meet deadlines</li>
</ul><ul><li>Design and participate in continuous quality improvement efforts.</li>
</ul><ul><li>Lead chart audits, prepare for inspections/site visits, manages corrective actions.</li>
</ul><ul><li>Ensure real-time PFDS data entry; submits monthly utilization and outcome data; supports quarterly quality/safety reports</li></ul> 


Why Gemma? Gemma offers a generous benefits package that includes full medical insurance coverage at no cost to the employee, eight (8) paid holidays and over three (3) weeks of paid time off in the first year. In addition, Gemma offers referral bonuses, education assistance and self-care funds for each program to participate in wellness activities.

This is a hybrid role: Monday &ndash; Friday, full-time position that is based out of our Preheim Center in Southwest Philadelphia. Flexible schedule preferred.

Experience and Education: Must have a minimum of three (3) years of experience working in healthcare, social services or education services setting with electronic record keeping. Experience in quality assurance preferred. A bachelor&rsquo;s degree in social service, population health or related field is required; master&rsquo;s degree preferred. Training in quality assurance methodologies, data systems, and compliance.
Equal Opportunity Employer 
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights (https://www.eeoc.gov/poster) notice from the Department of Labor.</div>

Quality Assurance Specialist- Rapid Service Response

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