Develop and implement comprehensive security policies, procedures, and programs to safeguard company assets, employees, and customers.Conduct regular risk assessments and security audits to identify vulnerabilities and implement appropriate mitigation measures.Manage and monitor security systems, including CCTV, access control, ensuring their optimal functionality.Investigate incidents of theft, fraud, and security breaches, collecting evidence, conducting interviews, and preparing detailed reports.Design and deliver training programs to educate employees on security protocols, loss prevention techniques,and quality assurance standards.Develop and maintain relationships with external stakeholders, such as vendors, clients, and regulatory authorities, to ensure compliance with security and quality standards.Oversee the implementation of quality control processes to monitor and evaluate service levels, identify areas for improvement, and ensure adherence to established standards.Analyze data and performance metrics to identify trends, patterns, and areas of concern, and develop strategies to address them.Conduct regular audits of operational processes and documentation to ensure compliance with quality assurance standards.Collaborate with cross-functional teams to resolve quality-related issues and implement corrective actions.Stay updated with industry trends, emerging technologies, and best practices in security management and quality assurance.

Conduct comprehensive audits of mental health claims to ensure accuracy, compliance, and adherence to regulatory guidelines and company policies.Review claim documentation, coding, and billing practices to identify discrepancies, errors, and potential fraudulent activities.Verify that claims meet medical necessity criteria and are supported by appropriate documentation.Evaluate claim processing accuracy, including proper coding, bundling, and modifiers.Collaborate with internal departments, including claims processing teams and compliance officers, to address audit findings and implement corrective actions.Provide feedback, training, and guidance to claims processors and billing staff to improve accuracy and compliance.Stay updated with industry regulations, reimbursement guidelines, and coding changes related to mental health claims.Monitor key performance indicators (KPIs) and quality metrics to identify trends, patterns, and areas for improvement.Prepare detailed audit reports, highlighting findings, recommendations, and areas of improvement to management.Assist in the development and implementation of quality assurance policies, procedures, and training programs.

Process and adjudicate mental health claims in accordance with insurance policies and reimbursement guidelines.Verify patient eligibility, benefits, and pre-authorization requirements for mental health services.Accurately assign appropriate medical codes (CPT, ICD-10, HCPCS) to ensure proper billing and reimbursement.Review documentation and medical records to ensure compliance with coding and billing standards.Collaborate with healthcare providers and insurance companies to resolve claim issues and discrepancies.Communicate with patients regarding insurance coverage, claim status, and billing inquiries.Maintain accurate and organized records of claims, payments, and denials.Stay updated with changes in insurance regulations, mental health coding guidelines, and reimbursement policies.Assist in training and mentoring new team members on claims processing procedures.Contribute to process improvement initiatives to enhance efficiency and accuracy in claims processing.