Quality Assurance Analyst RCM

ROLE:  

Facility Contracting & Quality Assurance (QA) Services analyst is responsible for the review and auditing of facility contracts to include but not limited to reviewing the billing accuracy after the contract has been entered into the billing system for all lines of business.

TASKS AND RESPONSIBILITIES:

• Primary point of contact for contractual billing questions and/or concerns from internal/external customers.
• Audits the correctness of all facility contracts and FDS entered by AMS (RCM Application Management Support)
• Work with Sales Reps/RGM’s to obtain all outstanding contracts.
• Responsible for assisting with the transition of the acquisition process, to include review of contracts, invoicing pricing and auditing the accuracy of information in appropriate systems.
• Serves as the primary point of contact for acquisitions to ensure smooth transition for clients and Billing Team.
• Track all DDF, IDX, and TELCOR changes related to facility billing.
• Identifies, Interprets and Evaluates inconsistencies, discrepancies and inaccuracies in DDF files then initiates corrective methods as needed.
• Perform monthly billing audits to ensure we are operating in compliance with all company policies/procedures, government and contractual requirements.
• Keeps the Manager of Facility Contracting & Quality Assurance (QA) advised of concerns and compliance issues.
• Assists Contracting & (QA) Manager in the management and financial performance of the business office functions.
• Support Facility Billing Leadership and assume other tasks as assigned to support the goals of the company.
• ServiceNow Ticketing Tracking/Completion

Other Duties

• Timely response to internal and external customer via email/voicemail.
• Audit all changes made to DDF, IDX, or TELCOR billing systems for accuracy.

Operations Management

• Assists with management of the functionality and efficient operation of the Facility Billing System to ensure accurate billing.

 

 

SKILLS/EXPERIENCE:

• S. Degree Finance, Accounting or Healthcare preferred.
• Stellar oral, written and interpersonal communication skills.
• Minimum of Five (5) years facility billing experience
• Minimum of Five (5) years facility contract analytics.
• Experience with healthcare billing system solutions and Microsoft Office.
• Strong organizational skills and attention to detail with the ability to meet multiple deadlines.
• Strong experience in managing within a dynamic, challenging and fast pace environment while working inclusively with people to achieve shared objectives.

 

PHYSICAL DEMANDS:

The physical demands described here 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.

While performing the duties of this job, the employee is frequently required to stand; to handle or feel; to talk and to hear.  The employee is occasionally required to walk, sit, reach with hands and arms and stoop, kneel, crouch or crawl.  The employee must occasionally lift and or move up to 15 pounds.  Specific vision abilities required by this job include close vision, depth perception and ability to adjust focus.

WORK ENVIRONMENT:

Standard office environment.

Pay Rate: $43-44K

Benefits: 

                TridentCare offers a competitive wage and robust benefit package to full time employees.  Part time employees are eligible for many of the same below, pro-rated.  Benefits include:

• Two weeks of vacation time
• Health Insurance after 30 days!
• Sick time
• 8 paid holidays
• Same day pay available
• Medical insurance allowance, giving you the freedom to customize your plan to fit your needs
• Dental insurance
• Vision insurance
• Disability insurance
• Company paid life insurance
• 401(k)

Qualifications Skills Required Microsoft Office Advanced Computer Skills Advanced Customer Service Advanced Analysis Intermediate Behaviors Required Thought Provoking: Capable of making others think deeply on a subject Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well Education Preferred Associates or better. High School or better. Some college or better. Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.