Remote Quality Assurance Analyst - Medical Billing
About the position
Crossroads Treatment Centers is seeking a Remote Quality Assurance Analyst to join their team. This role involves analyzing staff-worked accounts and patient accounting information to ensure payment resolutions and adherence to company policies. The analyst will contribute to the development and maintenance of QA processes, identify workflow improvements, and communicate findings to management. The position requires a strong understanding of physician billing, accounts receivable follow-up, and various payer portals. The ideal candidate will be self-sufficient, detail-oriented, and possess excellent critical thinking and communication skills, with the ability to work effectively both independently and as part of a team in a remote environment.
Responsibilities
• Performs all duties and responsibilities in accordance with local, state, and federal regulations and company policies.
• Leverages available resources and systems to analyze staff worked accounts and patient accounting information and take appropriate action for payment resolutions; documents all activity in accordance with organizational and client policies.
• Contributes to the development, implementation, and maintenance of the processes, workflows, and Policies and Procedures utilized by the QA Department.
• Assesses opportunities to improve internal workflows; ensures best methods and tools are utilized.
• Discusses results related to productivity and quality assurance with the appropriate management team; discusses coaching and development needs with management teams and partners.
• Helps to develop, maintain, and update documentation and reference manuals related to production and QA programs within the department.
• Communicates professionally (in all forms) with payer resources to include websites/payer portals, e-mail, telephone, staff members, etc.
• Assists the management team by working collaboratively and professionally with operational staff.
• Provides quality and productivity results at a level that meets departmental standards, timing as outlined by Director/VP.
• Compiles consistent reporting statistics to document team performance.
• Actively contributes to and achieves team performance of set Operational Goals and objectives.
• Analyzes accounts with critical thinking; utilizes departmental DLP, process guides, policies to ensure staff are utilizing resources provided.
• Other Duties as Assigned
Requirements
• Be 100% self-sufficient when completing productivity and QA assessments, showing expertise and knowledge working independently, while utilizing critical thinking and a solution-oriented mindset.
• Can take initiative when needed to share trends with leadership.
• Possess thorough understanding of physician billing, accounts receivable follow-up, charge entry, cash posting, eligibility and benefits, authorization, referrals, transaction review, adjustment posting, etc.
• Proven track record with working in QA analyst role.
• Proven experience utilizing payer portals including but not limited to: Availity, NaviNet, Change, Waystar, and others.
• Must be accustomed to working in a productivity/quality-based environment.
• Ability to efficiently work in a remote environment to include good time management skills and timely communication with co-workers.
• Required proficiency in the use of computers and computer software.
• Ability to use email and chat functions, navigate websites and portals, intermediate level of experience with spreadsheets, word processing and other required software applications.
• Strong written and verbal communication skills.
• Follow oral and written instructions and follow through on all assignments.
• Excellent organizational skills.
• Highly detailed-oriented.
• Ability to work well in a group setting and independently.
• Ability to prepare organized memoranda, spreadsheets, graphs, and correspondence.
• Strong ability to work independently and as a team member with peers.
• Fluent knowledge of entire revenue cycle process.
• Must have had at least 2 years quality assurance experience in a physician office setting.
• General Knowledge of HCPCS, CPT-4 and ICD-10 coding and/or medical terminology.
• Data analysis and interpretation of findings.
• Must have a High School Diploma/GED.
Nice-to-haves
• Excellent training if you are new to this field.
Benefits
• Medical, Dental, and Vision Insurance
• PTO
• Variety of 401K options including a match program with no vesture period
• Annual Continuing Education Allowance (in related field)
• Life Insurance
• Short/Long Term Disability
• Paid maternity/paternity leave
• Mental Health day
• Calm subscription for all employees
• Mileage reimbursement (if applicable) Crossroads matches the current IRS mileage reimbursement rate.
• Community events that promotes belonging and education . Includes but not limited to community cook outs, various fairs related to addiction treatment and outreach, parades, addiction awareness for schools, and holiday events.
Crossroads Treatment Centers is seeking a Remote Quality Assurance Analyst to join their team. This role involves analyzing staff-worked accounts and patient accounting information to ensure payment resolutions and adherence to company policies. The analyst will contribute to the development and maintenance of QA processes, identify workflow improvements, and communicate findings to management. The position requires a strong understanding of physician billing, accounts receivable follow-up, and various payer portals. The ideal candidate will be self-sufficient, detail-oriented, and possess excellent critical thinking and communication skills, with the ability to work effectively both independently and as part of a team in a remote environment.
Responsibilities
• Performs all duties and responsibilities in accordance with local, state, and federal regulations and company policies.
• Leverages available resources and systems to analyze staff worked accounts and patient accounting information and take appropriate action for payment resolutions; documents all activity in accordance with organizational and client policies.
• Contributes to the development, implementation, and maintenance of the processes, workflows, and Policies and Procedures utilized by the QA Department.
• Assesses opportunities to improve internal workflows; ensures best methods and tools are utilized.
• Discusses results related to productivity and quality assurance with the appropriate management team; discusses coaching and development needs with management teams and partners.
• Helps to develop, maintain, and update documentation and reference manuals related to production and QA programs within the department.
• Communicates professionally (in all forms) with payer resources to include websites/payer portals, e-mail, telephone, staff members, etc.
• Assists the management team by working collaboratively and professionally with operational staff.
• Provides quality and productivity results at a level that meets departmental standards, timing as outlined by Director/VP.
• Compiles consistent reporting statistics to document team performance.
• Actively contributes to and achieves team performance of set Operational Goals and objectives.
• Analyzes accounts with critical thinking; utilizes departmental DLP, process guides, policies to ensure staff are utilizing resources provided.
• Other Duties as Assigned
Requirements
• Be 100% self-sufficient when completing productivity and QA assessments, showing expertise and knowledge working independently, while utilizing critical thinking and a solution-oriented mindset.
• Can take initiative when needed to share trends with leadership.
• Possess thorough understanding of physician billing, accounts receivable follow-up, charge entry, cash posting, eligibility and benefits, authorization, referrals, transaction review, adjustment posting, etc.
• Proven track record with working in QA analyst role.
• Proven experience utilizing payer portals including but not limited to: Availity, NaviNet, Change, Waystar, and others.
• Must be accustomed to working in a productivity/quality-based environment.
• Ability to efficiently work in a remote environment to include good time management skills and timely communication with co-workers.
• Required proficiency in the use of computers and computer software.
• Ability to use email and chat functions, navigate websites and portals, intermediate level of experience with spreadsheets, word processing and other required software applications.
• Strong written and verbal communication skills.
• Follow oral and written instructions and follow through on all assignments.
• Excellent organizational skills.
• Highly detailed-oriented.
• Ability to work well in a group setting and independently.
• Ability to prepare organized memoranda, spreadsheets, graphs, and correspondence.
• Strong ability to work independently and as a team member with peers.
• Fluent knowledge of entire revenue cycle process.
• Must have had at least 2 years quality assurance experience in a physician office setting.
• General Knowledge of HCPCS, CPT-4 and ICD-10 coding and/or medical terminology.
• Data analysis and interpretation of findings.
• Must have a High School Diploma/GED.
Nice-to-haves
• Excellent training if you are new to this field.
Benefits
• Medical, Dental, and Vision Insurance
• PTO
• Variety of 401K options including a match program with no vesture period
• Annual Continuing Education Allowance (in related field)
• Life Insurance
• Short/Long Term Disability
• Paid maternity/paternity leave
• Mental Health day
• Calm subscription for all employees
• Mileage reimbursement (if applicable) Crossroads matches the current IRS mileage reimbursement rate.
• Community events that promotes belonging and education . Includes but not limited to community cook outs, various fairs related to addiction treatment and outreach, parades, addiction awareness for schools, and holiday events.