Quality Assurance Nurse

Medical Billing and CodingMedical Billing and CodingFull TimeRemote

Location

United States

Posted

17 days ago

Salary

Not specified

No structured requirement data.

Job Description

The Quality Assurance Nurse works in partnership with, and under the direction of, the Risk and Quality Management Director and the Administrative Manager of Centralized Follow-Up (CFU). This role supports key Risk & Quality Management (RQM) functions within Clinical Services and patient follow-up. The Quality Assurance Nurse is responsible for identifying documentation issues through accurate medical record auditing and providing actionable recommendations to improve clinical compliance. This position plays a critical role in promoting patient safety and ensuring the delivery of high-quality care. The Quality Assurance Nurse must be able to work both autonomously and collaboratively with leadership and clinical teams, including the Chief Medical Officer, Clinical Director of Family Planning, Health Center Managers, Clinicians, and Registered Nurses across the affiliate. Position Details Location: Remote or Hybrid Hybrid options: With the service areas of NC, SC, or VA only (dependent on available facility space) Remote options: Within the service areas of NC, SC, VA, WV, OH, or PA. Schedule: Full-Time, Monday–Friday, 9:00 AM–5:00 PM (40 hours/week) Work Distribution: 75% chart audits and audit-related tasks 25% patient follow-up responsibilities 75% chart audits and audit-related tasks 25% patient follow-up responsibilities Who You Are You believe reproductive health care is essential to every person’s overall health, well-being, and quality of life Experienced working with multiple state regulatory requirements Comfortable collaborating with staff at all levels of an organization Results-oriented with the ability to work independently Enjoy structured, detail-oriented, and repetitive work Highly organized with strong attention to detail Excellent time management and prioritization skills Able to work both autonomously and collaboratively What You’ll Do Conduct chart audits for patient encounters using affiliate-specific guidelines and clinical knowledge to ensure accurate and compliant medical record documentation Develop or revise audit tools in collaboration with relevant staff, as needed Identify opportunities to improve documentation quality and clinical compliance Contribute to communication and training plans to address identified deficiencies Serve as a quality assurance and compliance resource during training initiatives, as requested Maintain regular communication with appropriate staff regarding audit findings and trends Support Contact Center Patient Access Representatives by addressing patient questions, performing initial assessments, and providing education and support as appropriate Respond to patient inquiries related to healthcare services, including reproductive health care, STI services, birth control, primary care, gender-affirming hormone therapy (GAHT), and medication and surgical abortion, while maintaining strict confidentiality Triage laboratory results for all providers, prioritizing urgent notifications Initiate care pathways based on PPSAT Medical Standards & Guidelines (MS&Gs) and CFU RN Standing Orders Communicate results and next steps to Clinicians, Health Care Assistants, Clinical Director of Family Planning, and Health Center Managers as appropriate Support systems for task management, follow-up, and interdepartmental coordination Contribute to a positive work environment through collaboration, initiative, and problem-solving Adhere to affiliate policies, procedures, meeting requirements, and training expectations Perform other duties as assigned What You’ll Bring to the Role Bachelor’s degree in Nursing from an accredited institution Current Registered Nurse license in one of the service area states (SC, NC, VA, WV, OH, or PA) or a compact member state Minimum of 4 years of experience as a Registered Nurse At least 2 years of high-volume Electronic Health Record auditing experience in a healthcare setting Familiarity with industry-standard auditing practices Strong ability to interpret written guidelines related to compliance Exceptional attention to detail and accuracy Strong organizational and time management skills Preferred: Experience with EPIC Preferred: Experience in reproductive healthcare Preferred: Experience in lab/test management What We Offer Medical, dental, and vision insurance Health Reimbursement Account (HRA) 403(b) retirement plan with employer match Generous paid time off and holiday pay Employee Assistance Program (EAP) Compensation Transparency: This position is aligned within our established pay structure, with an annual salary range of $69,000–$89,000. Starting salary will be determined based on relevant experience and internal equity.

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