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Quality Assurance Clerk/Technician

Serco

Richmond, Virginia, United States

Richmond, Virginia, United States

Über

Position Description & Qualifications The Centers for Medicare & Medicaid Services (CMS) Comprehensive Error Rate Testing (CERT) program plays a vital role in safeguarding the integrity of the Medicare Fee-for-Service (FFS) program by ensuring that taxpayer-funded healthcare payments are accurate, appropriate, and compliant with federal requirements. Supporting CMS’s obligations under the Payment Integrity Information Act (PIIA), the program uses statistically valid sampling and independent medical review of claims to identify improper payments and measure program performance. The insights generated through CERT enable CMS to strengthen accountability, improve healthcare delivery practices, and drive corrective actions that protect both beneficiaries and public funds. Through this work, the CERT program helps uphold transparency, stewardship, and trust in one of the nation’s most critical healthcare systems.
This position is responsible for initiating and monitoring identified quality assurance activities related to the CERT program with a focus on Inter-Rater Reliability (IRR) and periodic audit requirements, including compliance with contract deliverables Statement of Work (SOW), internal/external performance requirements and continual improvement.
In this role, you will:
Prepare and monitor the IRR process from sample initiation through Panel preparation.
Maintain documents/records/files related to quality assurance activities (with a focus on IRR, periodic audit preparation/materials collection; licensure confirmation; task tracking)
Provide quality assurance data and information to the QA Manager for task order reports.
Input data into identified computer systems with a focus on the IRR module components.
Effectively communicate with management and employees (via email and/or phone, feedback form development, Excel data).
Comply with departmental policies and procedures.
Perform other projects or responsibilities as assigned by department manager (in collaboration with another department management).
To be successful in this role, you must have:
High school diploma.
At least 3 years of work experience in a medical office or medical records setting.
Must be flexible and adjust to changing priorities.
Must have effective time management and prioritization skills; able to multitask and work independently with limited oversight.
Knowledge of medical record processing.
Knowledge of medical terminology.
Ability to work under pressure and within designated time constraints.
Ability to solve problems and resolve issues as they arise.
Adept with multiple software including MS Office, Excel, Outlook, Zoom, Teams, and other programs.
Effective communication skills, adherence to PHI/PII and other confidentiality requirements.
Additional desired qualifications:
Bachelor’s degree in Public Health or a public administration related field.
Equal Opportunity Employer Serco is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.
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Richmond, Virginia, United States

Sprachkenntnisse

English

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