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The Quality Audit Professional analyzes and investigates quality issues. The Quality Audit Professional work assignments are varied and frequently require interpretation and independent determination of the appropriate courses of action.

The Quality Audit Professional collects and reviews records, summarizes issues, works with Medical director, and implements corrective actions as needed. Coordinate Peer review committees. Audits quality cases for compliance. Understand department, segment, and organizational strategy and operating goals, including their linkages to related areas. Makes decisions regarding own work methods, occasionally in ambiguous situations, and requires minimal direction and receives guidance where needed. Follows established guidelines/procedures.

Comprehensive medical reviews will be conducted on applied behavior analysis providers' claims for all BH specified CPT codes, coordination of care and...