Quality Assurance Specialist

Job Overview The Quality Assurance (QA) Specialist is responsible for ensuring the quality, accuracy, completeness, and compliance of all Disability Benefits Questionnaire (DBQ) consultation files and related medical documentation before they are released to veterans or referring organizations.

This role supports PMLC Consulting Group's Veterans Evaluation & DBQ Services Division by conducting quality reviews of client records, provider documentation, intake files, and operational processes to ensure compliance with company standards, HIPAA requirements, and applicable government contracting requirements.

The QA Specialist does not make medical determinations, alter provider findings, provide legal advice, or represent veterans before the Department of Veterans Affairs (VA).

Duties

* Scope of WorkQuality Assurance Reviews

Review completed case files to verify

• Client intake documentation is complete.
• Required medical records have been received.
• Consent forms have been signed.
• HIPAA documentation is complete.
• Required provider documentation has been included.
• DBQs are complete, signed, dated, and internally consistent.
• Supporting documentation matches the reported medical findings.
• Administrative records are accurate before release.

Qualifications

• Required
• Bachelor's degree in Healthcare Administration, Nursing, Health Information Management, Public Health, Business Administration, Quality Management, or a related field (or equivalent experience).

Preferred

• Experience with VA disability processes or veteran healthcare.
• Knowledge of Disability Benefits Questionnaires (DBQs) and medical documentation standards.
• Experience supporting federal or state government contracts.
• Familiarity with HIPAA and healthcare compliance requirements.
• Experience with electronic medical record (EMR) or case management systems.

Preferred Certifications

• Certified Professional in Healthcare Quality (CPHQ)
• Certified Professional Compliance Officer (CPCO)
• Certified Professional Medical Auditor (CPMA)
• Lean Six Sigma Green Belt (preferred)
• Project Management Professional (PMP) (preferred)
• Minimum of three years of experience in quality assurance, healthcare administration, medical records, compliance, auditing, or case management.
• Experience reviewing medical or regulated documentation.
• Strong attention to detail and organizational skills.
• Excellent written and verbal communication skills.

Pay: $25.00 - $35.00 per hour

Work Location: Remote