Quality Audit Associate
About Paradigm
Paradigm is an accountable specialty care management organization focused on improving the lives of people with complex injuries and diagnoses. The company has been a pioneer in value-based care since 1991 and has an exceptional track record of generating the very best outcomes for patients, payers, and providers. Deep clinical expertise is the foundation for every part of Paradigm’s business: risk-based clinical solutions, case management, specialty networks, home health, shared decision support, and payment integrity programs.
Paradigm is proud to be recognized for the fourth consecutive year as a Great Place to Work® and for the third year in a row on Fortune's Best Workplaces in Health Care™ list, reflecting an unwavering commitment to fostering a positive, inclusive, and employee-centric culture.
Responsibilities
- Learn and adhere to account guidelines.
- Use account guidelines to complete case billing audits.
- Research and investigate short pays, non-pays, and document appropriately in the collections application.
- Perform internal audits.
- Run queries with customer-specific data.
Requirements
- High school diploma or equivalent required; post-secondary education preferred.
- Excellent computer skills, especially with data entry.
- Intermediate to advanced Microsoft Outlook and Excel skills.
- Strong interpersonal communication skills, both verbal and written.
- Strong attention to detail.
- Organizational skills and ability to multitask and prioritize.
- Ability to exercise sound judgment and maintain confidentiality.
Benefits
- Health and wellness: PPO, HDHP, and HMO health insurance options with Cigna and Kaiser (CA employees only).
- Financial incentives: Competitive salaries, 401(k) matching contributions, employer-paid life and disability insurance, flexible spending and commuter accounts, and employer-matched HSA contributions.
- Vacation: Paid time off and personal holiday programs for work-life balance.
- Volunteer time: One paid day per calendar year for community engagement.
- Learning and development: Support for continuous learning and growth, including the Learning Excellence at Paradigm (LEAP) program.
Schedule
Monday - Friday, 8 AM to 5 PM.