Quality Audit Specialist – Revenue Cycle Management (RCM)

Job ID2023-25420

Positions 5 Job Location US-Remote Telecommute Telecommute (U.S.) Position FT/PT Full-Time Category More Key Contributors

Why Us?
With a mantra of Empowering Human Potential, Hanger, Inc. is the world’s premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger’s Patient Care segment is the largest owner and operator of O&P patient care clinics nationwide. Through its Products & Services segment, Hanger distributes branded and private label O&P devices, products and components, and provides rehabilitative solutions to the broader market. With 160 years of clinical excellence and innovation, Hanger’s vision is to lead the orthotic and prosthetic markets by providing superior patient care, outcomes, services and value. Collectively, Hanger employees touch thousands of lives each day, helping people achieve new levels of mobility and freedom.

Could This Be For You?
We are seeking an RCM Quality Audit Specialist I – Remote. This position reports to the Manager of RCM Quality Audit as part of the Revenue Cycle Performance Group, the Revenue Cycle Quality Auditor position is an integral role in the success of the Revenue Cycle team. The Revenue Cycle Quality Auditor is responsible for performing routine and targeted quality audits of both offshore and onshore processes, ensuring that quality and performance standards are being met. The ideal candidate for this role has extensive revenue cycle experience, an eagerness for training and education and exhibits a patient and calm demeanor.

Your Impact
Responsible for performing & maintaining the quality assurance processes for Revenue Cycle functions across the organization, with an intense focus on offshore processes.
Performs routine and targeted audits to ensure quality and compliance standards are met.
Processes error disputes, providing timely feedback to staff.
Performs account review for account financial resolution opportunities and performance opportunities.
Observes areas for operational workflow opportunities.
Analyzes trends in data, making appropriate recommendations for additional training as needed.
Working directly with the RCM Quality Audit Manager, prepare and participate in re-education/ training sessions with onshore and offshore staff to remediate quality deficiencies.
Minimum Qualifications
1 year of relevant work experience within healthcare revenue cycle
Excellent written and oral communication skills
Strong analytical, problem solving, trouble shooting skills
Skilled in the use and application of Microsoft Office Suite (Power Point, Word, Excel, Outlook)
Ability to demonstrate a calm demeanor in stressful work situations
Prior experience auditing revenue cycle processes preferred
Additional Success Factors
Act with integrity in all ways and at all times, remaining honest, transparent, and respectful in all relationships.
Keep the patient at the center of everything that you do, building lifelong trust.
Foster open collaboration and constructive dialogue with everyone around you.
Continuously innovate new solutions, influencing and responding to change.
Focus on superior outcomes, and calibrate work processes for outstanding results.
Our Investment in You
Employees working at least 20 hours per week are eligible for the following benefits:

Competitive Pay
Health Insurance
Dental Insurance
Vision Insurance
8 Paid Holidays per Year
Paid Vacation Time Off
Paid Sick Time Off
8 hours of paid time to volunteer in your community
Floating Holiday
Life Insurance
Medical Flex Spend Account
Dependent Care Flex Spend Account
Free employee assistance program
401(k)
Full-time employees are also eligible for short-term and long-term disability insurance

LI-Remote

Pay range of $16.00 to $22.00 per hour + annual bonus: up to 5% of base pay depending on bonus criteria. This pay range is posted to comply with wage transparency laws. Hanger salary ranges vary based on skill, ability, knowledge, geographic location and other variables.

Quality Assurance Coordinator

Overview
Are you a CNA (Certified Nursing Assistant) or MA (Medical Assistant) looking to step away from a medical office and into a remote position?

If you answered yes, then this might be the job for you because ExamWorks is looking for a Quality Assurance Coordinator for our team. You will be responsible for reading medical reports ensuring accuracy by searching for any errors in grammar, medical terminology, and content before sending to our clients.

This position is 100% remote. Candidate must be available to work Monday through Friday 8:30am-5:00pm CT.

Want to join an employee-first company with great benefits and growth opportunities? If you think this aligns with what you desire in your next career move, apply at this very moment!

Responsibilities
Performs quality assurance review of IME reports, correspondences, addendums or supplemental reviews.
Ensures clear, concise, evidence-based rationales have been provided in support of all recommendations and/or determinations.
Ensures that all client instructions and specifications have been followed and that all questions have been addressed.
Ensures each review is supported by clinical citations and references when applicable and verifies that all references cited are current and obtained from reputable medical journals and/or publications.
Ensures the content, format, and professional appearance of the reports are of the highest quality and in compliance with company standards.
Ensure that the appropriate board specialty has reviewed the case in compliance with client specifications and/or state mandates and is documented accurately on the case report.
Verifies that the peer reviewer has attested to only the fact(s) and that no evidence of reviewer conflict of interest exists.
Ensures the provider credentials and signature are adhered to the final report.
Identifies any inconsistencies within the report and contacts the Provider to obtain clarification, modification or correction as needed.
Assists in resolution of customer complaints and quality assurance issues as needed.
Ensures all federal ERISA and/or state mandates are adhered to at all times.
Provides insight and direction to management on consultant quality, availability and compliance with all company policies and procedures and client specifications.
Promote effective and efficient utilization of company resources.
Participate in various educational and or training activities as required.
Perform other duties as assigned.
Qualifications
High school diploma or equivalent required.
Two years of medical office experience.
Must have strong knowledge of medical terminology, anatomy and physiology, medications and laboratory values.
Qualified typist with a minimum of 40 W.P.M preferred
Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
Must possess excellent skills in English usage, grammar, punctuation and style.
Ability to follow instructions and respond to upper managements’ directions accurately.
Demonstrates accuracy and thoroughness.
Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed.
Must be able to work independently, prioritize work activities and use time efficiently.
Must be able to maintain confidentiality.
Must be able to stay focused and concentrate under normal or heavy distractions.
Must be able to work well under pressure and or stressful conditions.
Must possess the ability to manage change, delays, or unexpected events appropriately.
Demonstrates reliability and abides by the company attendance policy.

ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers’ compensation insurance coverages.

ExamWorks, LLC is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities and all individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age or any other status protected under local, state or federal laws.

ExamWorks offers a fast-paced team atmosphere with competitive benefits (medical, vision, dental), paid time off, and 401k.

Equal Opportunity Employer – Minorities/Females/Disabled/Veterans

Data Entry Associate

Overview

Preference will be given to those who have experience with medical bills, ICD’s and CPT’s.

Joining ExamWorks as a Data Entry Associate may be the best decision you ever make. 

We are seeking a medical billing-savvy professional who is keen to pick up on important details and looking to thrive in a fast-paced, growing environment.  

This position is 100% remote. Candidate must be available to work 8:00am-5:00pm PST; Monday through Friday. Office equipment (office phone, screen, keyboard, mouse and virtual desktop) will be provided.

The hourly rate of pay for this role is between $16.00-$16.50.

If you’re ready for a change, let’s hear from you!

Responsibilities

ESSENTIAL DUTIES AND RESPONSIBILITIES TO PERFORM THIS JOB SUCCESSFULLY INCLUDE, BUT ARE NOT LIMITED TO THE FOLLOWING:

  • Gathers, organizes and prepares source documents for data entry into the appropriate system database.
  • Reviews data for discrepancies, missing pages or information and resolves discrepancies by using standard procedures or returning incomplete documents to the team leader for resolution.
  • Enters both alphabetic and numeric data from source documents into the proper system database.
  • Reviews data entered against the original source documents for accuracy and corrects any data entry errors or duplications.
  • Follows data program security practices and procedures at all times.
  • Routinely secures information by completing database backup daily.
  • Performs other varies clerical duties such as sorting, filing, emailing and proofreading as required.
  • Maintains confidentiality of all personal and financial information at all times and in accordance with HIPPA regulations.
  • Perform other duties as assigned.

Qualifications

EDUCATION AND/OR EXPERIENCE 

High school diploma or equivalent required. A minimum of 6 months related experience; or equivalent combination of training and experience. Experience in a medical office preferred.

QUALIFICATIONS 

  • Must possess complete knowledge of general computer, fax, copier, scanner, and telephone.
  • Must be knowledgeable of multiple software programs, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
  • Must have a full understanding of HIPAA regulations and compliance.
  • Must be a qualified typist with a minimum of 40 W.P.M.
  • Ability to follow instructions and respond to managements’ directions accurately.
  • Demonstrates accuracy and thoroughness. Looks for ways to improve and promote quality and monitors own work to ensure quality is met.
  • Must demonstrate exceptional communication skills by conveying necessary information accurately, listening effectively and asking questions where clarification is needed.
  • Must be able to work independently, prioritize work activities and use time efficiently.
  • Must be able to maintain confidentiality.
  • Must be able to demonstrate and promote a positive team -oriented environment.
  • Must be able to stay focused and concentrate under normal or heavy distractions.
  • Must be able to work well under pressure and or stressful conditions.
  • Must possess the ability to manage change, delays, or unexpected events appropriately.
  • Demonstrates reliability and abides by the company attendance policy.
  • Must maintain a professional and clean appearance at all times consistent with company standards.

ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers’ compensation insurance coverages.

Examworks offers a fast-paced team atmosphere with competitive benefits, paid time off, and 401k. 

Examworks is an Equal Opportunity Employer and affords equal opportunity to all qualified applicants for all positions without regard to protected veteran status, qualified individuals with disabilities and all individuals without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age or any other status protected under local, state or federal laws.

Equal Opportunity Employer – Minorities/Females/Disabled/Veterans

Streaming Operations Coordinator

locations
New York
time type
Full time
posted on
Posted 9 Days Ago
job requisition id
R0007910
Work Locations: With the exception of some select roles that have in-office requirements, A+E Networks operates on a flexible model that allows for remote, hybrid or full time in office work (in certain locales).

Office locations include New York City, Los Angeles, Chicago, and Stamford, CT.

Our list of eligible states in which employees may work remotely includes: California, Connecticut, Florida, Georgia, Illinois, Indiana, Maryland, Massachusetts, Michigan, Minnesota, Nevada, New Hampshire, New Jersey, New York, North Carolina, Oregon, South Carolina, South Dakota, Texas, West Virginia, Wisconsin, and Wyoming.

Division Story
Fourteen straight years of double digit growth. Thanks to our International Team, which specializes in taking US hits and making them global hits. We are an energetic group of die-hard travelers with a strong track record of identifying and acquiring winning programming from the English language, European and Asian markets. We currently manage 76 channels around the world with staff offices in London, Rome, Tokyo, Seoul, Munich and Singapore, and we’re fluent in at least 42 languages. Parlez-vous français? Ni hui shuo zhongwen ma? If you answered “yes” (in any language) and enjoy having your passport stamped, our department might just be your next destination.
Job Description
THE ROLE: Streaming Operations Coordinator
The Streaming Operations Coordinator will assist in the day-to-day operations for free ad supported television (FAST) channel scheduling by managing the flow of information between internal and external stakeholders to ensure timely delivery of programming assets to FAST vendors, as well as assist in the buildout of FAST playout schedules. This person will be responsible for managing the operational logistics and communication across key streaming partners including Samsung, Roku and Pluto.

MORE ABOUT WHAT YOU’LL DO:
The successful candidate will possess the following:

Provide primary product development and operations support to the GCS Scheduling and Broadcast Operation teams responsible for managing and maintaining program and playout schedules for streaming free ad supported television channels (FAST).

Act as a liaison across teams to ensure scheduling requirements and timelines are met for A+E’s portfolio of FAST channels.

Support manager with the daily operations for artwork, content fulfillment orders and metadata for A+E’s portfolio of FAST channels.

Maintain and execute daily FAST Airtable trackers and reports capturing critical scheduling and delivery information.

Monitor and troubleshoot daily FAST program and promo scheduling grids to guarantee final playout schedules are properly timed out.

Serve as a main escalation contact for troubleshooting issues pertaining to FAST channel playout streams.

Organize, track, and manage FAST channel stream escalation tickets with internal teams and vendors.

Communicate FAST schedules and legal takedowns to vendors and partners as necessary.

Play a critical role in implementing best operational practices across divisions in support of promo and short form scheduling within FAST channels.

Fulfill requests for enhanced metadata and artwork to 3rd party vendors (Gracenote/TiVo) to power partners’ platform menus and search for A+E FAST channels.

Support team in the implementation of new scheduling processes and/or systems for FAST channels, resulting in operational efficiencies and transparency across teams.

Identify, develop, and implement best-in-class practices across teams, focused on improving customer experience of FAST channels and additional digital content licensing platforms.

Monitor competitive landscape and industry trends. Support general business development efforts including industry research, due diligence, and creation of presentations.

YOUR STORY: [+BEHAVIORS] (what you need to have)

The candidate will have a four-year college degree

Knowledge of Word, Excel, PowerPoint, and Airtable are strongly preferred

A knowledge and passion for streaming television platforms

Compensation
Hourly Pay Range: $27.47 – $35.25
Annual Incentive Target: 5%

The annual/hourly pay range displayed serves as a good faith estimate of the

minimum and maximum base pay range for this role. Compensation for the role will

be based on a number of different factors such as a candidate’s qualifications, skills,

competencies, location, and experience. A+E offers a competitive total compensation

package, which includes healthcare coverage, 401k matching, and a range of other benefits. Learn more at aenetworks.com/careers.

A+E Networks is proud to uphold an equal opportunity employment policy and employs personnel without regard to race, creed, color, ethnicity, national origin, religion, sex, sexual orientation, gender expression, age, physical or mental ability, veteran status, military obligations, and marital status. This policy also applies to all employees, consultants, and third-party workers.
A&E Television Networks, LLC is a joint venture of Disney-ABC Television Group and Hearst Corporation.
We are proud to be an Affirmative Action/Equal Opportunity Employer/Disabled/Veterans.