QA Specialist (Healthcare - Durban)

Job Opening: QA Specialist

Location: Remote (Working US Hours - 9am-5pm EST)
Type: Full-Time

• Review clinical and administrative documentation to ensure accuracy, completeness, and compliance with company policies and insurance requirements.
• Conduct regular audits of patient records, treatment plans, session notes, and authorization documentation.
• Ensure compliance with regulatory standards, HIPAA requirements, and payer guidelines.
• Identify documentation errors, inconsistencies, or compliance risks and report findings to management.
• Provide feedback and recommendations to improve documentation quality and operational processes.
• Collaborate with clinical teams, scheduling staff, billing teams, and administrative departments to ensure processes align with compliance standards.
• Assist in the development and implementation of quality assurance policies, procedures, and SOPs.
• Track QA metrics and generate reports on compliance, documentation quality, and operational performance.
• Support internal audits and prepare documentation for external audits when required.
• Provide training and guidance to staff on proper documentation standards and compliance procedures.

• Bachelor's degree in Healthcare Administration, Psychology, Business Administration, or a related field preferred.
• Previous experience in ABA, behavioral health, healthcare administration, or medical compliance preferred.
• Strong understanding of ABA documentation standards, insurance requirements, and healthcare compliance.
• Knowledge of HIPAA regulations and patient confidentiality requirements.
• Strong attention to detail and analytical skills.
• Excellent organizational and problem-solving abilities.
• Ability to review large volumes of documentation while maintaining accuracy.
• Strong communication skills with the ability to provide constructive feedback.
• Proficiency in healthcare systems, EMRs/EHRs, and documentation platforms.
• Ability to work independently and manage multiple priorities.
• Comfortable working U.S. hours
• Remote work from home

Fraud Disclaimer: ReWorks Solutions will never request payment during recruitment or require in-person office visits. All official communication will come from a ReWorks Solutions email address. Please verify any suspicious messages with our team directly.