Jr QA (Entry Level)

Process Auditing & Record Review: Conduct routine structured audits of patient case files member records and documentation to verify accuracy completeness and compliance with institutional standards.

Data Collection & Entry: Accurately extract compile and maintain data from various health information systems to support quality scorecards and performance monitoring.

Regulatory Compliance Support: Assist in gathering documentation and prepping audit trails for scheduled state and federal reviews (CMS DOH NCQA HEDIS).

Trend Identification: Help monitor operational workflows and flag inconsistencies documentation gaps or deviations from established protocols to senior QA team members.

Reporting & Tracking: Maintain internal tracking logs compile compliance spreadsheets and assist in drafting basic data summary reports for quality improvement committees.

Cross-Functional Collaboration: Partner with clinical customer service and care management teams to clarify documentation inaccuracies and support corrective action plans.

Education: Bachelors degree in Healthcare Administration Public Health Health Information Management Business Administration or a related field.

Experience: 02 years of experience in an administrative analytical or auditing role. Experience or internships within a healthcare or health insurance setting are highly preferred.

Core Skills:

• Exceptional attention to detail and strong organizational skills.

• Intermediate proficiency with Microsoft Office Suite (particularly Excel functions like filtering sorting and basic data entry formatting).

• Ability to handle highly sensitive confidential patient information with strict adherence to HIPAA guidelines.

Communication: Strong written and verbal communication skills; comfortable reaching out to internal teams to gather or clarify data.

Familiarity with healthcare quality improvement frameworks (e.g. PDSA cycles Lean concepts).

Basic understanding of Medicaid/Medicare plan structures HEDIS metrics or clinical documentation standards.

Comfort learning new electronic health records (EHR) and database management software.