AcclaraRemote, United States
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Description
Job Title: Analyst, Quality Assurance – Physician Billing
Company: Acclara
Department: Client Experience and QA
Leader: Manager, Quality Assurance
FLSA Status: Hourly/Non-Exempt
Location: This position is remote within the U.S.
Travel: No travel required
Compensation: $17.09 – $28.19
The posted compensation range is a reasonable estimate that extends from the lowest to the highest pay Acclara in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. Acclara may ultimately pay more or less than the posted range as permitted by law.
OVERVIEW
The Quality Assurance Analyst is responsible for the quality assessment, audit, and analysis of assigned Acclara production staff in which the level of quality, as defined, is evaluated and scored.
Responsibilities include:
Routinely perform quality assurance account reviews for assigned teams and conduct full life cycle claim audits for assigned clients.
Utilize knowledge of billing best practices, including payor guidelines and/or coding compliance
Monitor inbound and outbound calls to complete quality assurance monitoring and assure proper patient interaction and client performance.
Assess quality of Insurance Services by reviewing and auditing accounts for timely and proper follow-up.
Audits defined company and/or project established processes.
Record results of all QA account assessments and audits.
Identify inefficiencies and process gaps that are contributing to decreases in performance and recommend best practices for ongoing process improvement.
Works with people leaders to standardize workflows and establish/improve processes to drive efficiency and increase productivity.
Participates in quality calibration initiatives with management, training, and operations team, resolves routine questions or problems, escalating complex issues to management as needed.
Utilizes audit findings to report on trends and recommend training modifications to management.
May perform HIPAA audits to ensure compliance with current HIPAA policies.
Meet with individual team members to conduct monthly quality assurance scoring and feedback sessions.
Coach team members individually to maximize training results, improve quality metrics, and increase client performance.
Facilitate new hire training sessions on internal and external systems.
Prepare and distributes quality assurance performance statistics.
Frequent calibration of quality assurance monitoring to ensure consistent administration of quality assurance objectives.
Other duties as assigned.
QUALIFICATIONS
High school diploma or equivalent.
2 years previous work experience in healthcare insurance collections, physician billing, revenue cycle quality assurance, or compliance and/or training.
Detailed understanding of healthcare revenue cycle operational processes such as the functions of insurance, patient billing & collections, Managed Care, Medicare, Medicaid, and Commercial Practices.
Ability to navigate through multiple software and computer applications.
Detail oriented and well organized.
Ability to focus completely on listening to calls, understanding the message, comprehending the information, and transferring knowledge to the QA process.
Ability to perform under pressure in a calm manner & maintain a positive attitude.
Basic math skills.
Collaboration skills.
Computer literate / able to use basic functions of a computer.
Strong analytical skills.
Excellent, customer service, verbal, written, listening and interpersonal skills.
Knowledge of EOBs, CPT & ICD-9 & 10 codes, HCFAs, UB92s, HCPCS, DRGs and
authorizations/ referrals.
Performs tasks with a high degree of accuracy.
Positively influence and promote teamwork within operational area.
Ability to motivate staff to improve performance.
Capacity to maintain a high level of objectivity when completing staff reviews.
Computer skills including Microsoft Office Suite.
Self-motivated and resourceful with the ability to multitask and meet deadlines under time pressures.
Preferred Qualifications:
College degree
Quality Assurance experience in professional revenue cycle services
Proficient in various healthcare software including EPIC, eClinical Works. Meditech, and/or NextGen
Physical Requirements:
The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Listed below are the physical requirements required while performing the duties of this job.
The employee is regularly required to: stand; sit; talk; hear; use hands and fingers to operate a computer and telephone keyboard; and reach, stoop and/or kneel to install computer equipment
The employee must have the specific vision ability to complete close vision requirements due to computer work
The employee is required to be able to complete light to moderate lifting
Our Commitment to Diversity, Equity, and Inclusion
We welcome and respect the variety of experiences, viewpoints, and cultural backgrounds that everyone brings to our workplace. Acclara makes every effort to promote a workplace where leaders model inclusive behaviors and individuals feel respected, valued, and empowered. Together, we promote and sustain an inclusive workplace where people feel a sense of belonging.