Overview
SQF Manager Jobs in Tampa, FL at Catalina Finer Food, LLC
Are you seeking personal and professional fulfillment? At Crossroads Turning Points, our employees can make a difference daily by helping individuals facing substance use and mental health challenges build healthy lifestyles supporting their long-term recovery. Our dedicated team provides personalized care to create an environment that fosters healing for everyone who walks through our doors.
We seek a dynamic individual to fill the Medicaid Quality Assurance Specialist position. Responsible for reviewing data provided by our Electronic Health Record (EHR) system and auditing patient HER documentation for Medicaid Requirements to ensure timely billing for patient services. Patient data will be used to compile and submit claims to Medicaid, Medicare, and private insurance companies.
All applicants must undergo pre-employment drug screening, which includes testing for marijuana, as well as background checks.
ESSENTIAL DUTIES AND RESPONSIBILITIES: Include the following. Other duties may be assigned.
Train WM and Outpatient staff on Medicaid role and CPT coding of HCPCS, ICD-10, and DSM-5 systems.
Work closely with Unit Supervisor(s)/Director(s) to ensure:
Audit for documentation quality and necessary signatures for insurance billing of patient services.
Billing processes comply with insurance contracts as well as state & federal regulations.
Communicate effectively and efficiently in both oral and written communication.
Attend all Quality Assurance Meetings and represent your respective areas.
Review daily patient records for accuracy, completeness of information, and Medicaid compliance.
Collaborate with the Insurance Coordinator and the Clinical and accounting Teams to review all chart/financial issues regarding insurance.
Unit Supervisor(s)/Director(s) will support efforts by ensuring the cooperation of clinical staff to achieve acceptable clinical records and billing of Medicaid services.
SUPERVISORY RESPONSIBILITIES: N/A
QUALIFICATIONS:
Education:
High School Diploma or G.E.D.
RHIT (Registered Health Information Technician) and/or associates in business administration or health information preferred.
On-the-job training will be provided. After 90 days, this knowledge will be assessed to determine the minimum required for this job.
Experience:
Minimum 1 (one) year of experience in Substance Misuse and/or Behavioral Health, preferable Withdraw Management experience.
Excel and Word proficiency at the intermediate level is preferred.
Experience in billing, especially Medicaid and third-party insurance, including, but not limited to, ICD-10 and DSM 5 and any other coding platforms preferred.
Other:
Valid driver’s license and insurability.
PHYSICAL DEMANDS:
Must be able to stand, walk, and sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
WORK ENVIRONMENT:
Office and/or Clinical Services Environment
DISCLAIMER:
The above information in this description has been designed to indicate the general nature and level of work employees perform with this classification. It is not intended to contain or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of employees assigned to this job.
We offer a competitive salary and an excellent package of benefits:
Medical (up to 70% paid by employer).
Dental & Vision Insurance.
Eight (8) Paid Holidays.
Two (2) Paid Administrative Holidays.
Career Advancement.
Retirement plan 401K with employer match up to 5%.
Many other benefits (free and optional).
Apply today at www.crossroadstp.org under the employment tab.
Join a leader in the behavioral health field with over 45 years of experience!
Closing Date:
June 4, 2025, or open until filled
Rate:
$21.17 per hour
EOE/M/F/D/V/SO
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Title: SQF Manager
Company: Catalina Finer Food, LLC
Location: Tampa, FL
