Quality Control Auditor (Remote)

About the Role

To work on registration and audit daily work done by offshore Data Entry teams. Ensure there is no delay with charges and that the charges are being posted correctly within the billing system. Determine if insurance received from facility is accurate and eligible for our Anesthesia services and update accordingly.

Responsibilities

• Manage and process assigned work queues in a timely and productive manner with high quality.
• Send requests for new surgeons to be added to the billing system.
• Recommend vendor education based on errors found while resolving work queue tasks.
• Review and correct insurance-related payor codes.
• Determine eligibility, insurance product and plan types for patient accounts utilizing Availity, payer websites, contact with payers, and hospital’s EMR.
• Ensure all insurance information is obtained and entered in the system in an accurate manner.
• Identify discrepancies in patient insurance information and correct the insurance information within the billing system timely.
• Review medical records, patient demographic sheets/face sheets and EMR systems. Make changes to the patient's account based on information reviewed.

Requirements

• High School Diploma or equivalent required.
• Ability to prioritize and manage multiple requests and respond within designated timeframe.
• Moderate computer skills.

Qualifications

• 1+ years of experience with insurance verification/Data Entry in the Medical field.
• Basic working knowledge of billing procedures, insurance reimbursement, and guidelines preferably in a medical or anesthesia setting.
• Basic knowledge of insurance plans along with understanding guidelines for Medicare/Medicaid, government plans, HMOs, and PPOs.
• One-year prior electronic medical records experience required (EMR/EHR).
• Beginner Excel, Word, and Outlook skills.
• Team player that develops strong collaborative working relationships with internal team and can effectively engage and ability to build consensus among cross-functional teams.
• Work requires focus, flexibility, and the ability to adapt to changing work situations.
• Ability to maintain department benchmark for quality and productivity.

Benefits

• Generous paid time off.
• Health, life, vision, dental, disability, and AD&D insurance.
• Flexible Spending Accounts/Health Savings Accounts.
• 401(k) retirement plan.
• Leadership and professional development opportunities.