Talentify.io
RCM: Quality Assurance Analyst - Remote
Talentify.io, Little Ferry, New Jersey, us, 07643
Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Job Description
The Quality Assurance Analyst will be accountable for inputting daily productivity results and completing daily quality assurance reviews for RCM staff as requested by VP/Director of RCM. The Analyst works with department leadership to ensure productivity and quality reviews are completed timely throughout the month, providing a final summary by the 5th business day of the following month for each employee in the RCM department. The Analyst will maintain/update current quality scorecards for various revenue cycle teams and provide suggestions on improvement in quality standards, providing trend analysis to Manager/Director.The Quality Assurance Analyst will work in conjunction with the RCM Manager/Director to identify opportunities for additional education/training. The Quality Assurance Analyst utilizes a variety of proprietary and external tools to research and review accounts worked by RCM staff. The Quality Assurance Analyst will be required to use multiple resources including payor portals, phone calls, and EMR systems to review various accounts.Essential Duties and Responsibilities
Perform all duties and responsibilities in accordance with local, state, and federal regulations and company policies.Leverage available resources and systems (both internal and external) to analyze staff worked accounts, patient accounting information, and take appropriate action for payment resolutions; document all activity in accordance with organizational and client policies.Contribute to the development, implementation, and maintenance of the processes, workflows, and Policies and Procedures utilized by the QA Department. Assess opportunities to improve internal workflows; ensure best methods and tools are utilized.Discuss results related to productivity and quality assurance with the appropriate management team; discuss coaching and development needs with management teams and partners.Help to develop, maintain, and update documentation and reference manuals related to production and QA programs within the department.Communicate professionally (in all forms) with payer resources to include websites/payer portals, e-mail, telephone, staff members, etc.Assist the management team by working collaboratively and professionally with operational staff.Provide quality and productivity results at a level that meets departmental standards, timing as outlined by Director/VP.Compile consistent reporting statistics to document team performance.Actively contribute to and achieve team performance of set Operational Goals and objectives.Analyze accounts with critical thinking; utilize departmental DLP, process guides, and policies to ensure staff are utilizing resources provided.Other Duties as Assigned.Qualification Requirements
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Required
Position requires constant mental alertness, attention to detail, and a high degree of accuracy required in completing all assignments. Strong problem-solving skills. Smart, driven, exceptional work ethic. Must be able to: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 a thorough understanding of physician billing, accounts receivable follow-up, charge entry, cash posting, eligibility and benefits, authorization, referrals, transaction review, adjustment posting, etc.Have a proven track record of working in a QA analyst role.Have proven experience utilizing payer portals including but not limited to: Availity, NaviNet, Change, Waystar, and others.Be accustomed to working in a productivity/quality-based environment.Have the ability to efficiently work in a remote environment, including good time management skills and timely communication with co-workers.
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Job Description
The Quality Assurance Analyst will be accountable for inputting daily productivity results and completing daily quality assurance reviews for RCM staff as requested by VP/Director of RCM. The Analyst works with department leadership to ensure productivity and quality reviews are completed timely throughout the month, providing a final summary by the 5th business day of the following month for each employee in the RCM department. The Analyst will maintain/update current quality scorecards for various revenue cycle teams and provide suggestions on improvement in quality standards, providing trend analysis to Manager/Director.The Quality Assurance Analyst will work in conjunction with the RCM Manager/Director to identify opportunities for additional education/training. The Quality Assurance Analyst utilizes a variety of proprietary and external tools to research and review accounts worked by RCM staff. The Quality Assurance Analyst will be required to use multiple resources including payor portals, phone calls, and EMR systems to review various accounts.Essential Duties and Responsibilities
Perform all duties and responsibilities in accordance with local, state, and federal regulations and company policies.Leverage available resources and systems (both internal and external) to analyze staff worked accounts, patient accounting information, and take appropriate action for payment resolutions; document all activity in accordance with organizational and client policies.Contribute to the development, implementation, and maintenance of the processes, workflows, and Policies and Procedures utilized by the QA Department. Assess opportunities to improve internal workflows; ensure best methods and tools are utilized.Discuss results related to productivity and quality assurance with the appropriate management team; discuss coaching and development needs with management teams and partners.Help to develop, maintain, and update documentation and reference manuals related to production and QA programs within the department.Communicate professionally (in all forms) with payer resources to include websites/payer portals, e-mail, telephone, staff members, etc.Assist the management team by working collaboratively and professionally with operational staff.Provide quality and productivity results at a level that meets departmental standards, timing as outlined by Director/VP.Compile consistent reporting statistics to document team performance.Actively contribute to and achieve team performance of set Operational Goals and objectives.Analyze accounts with critical thinking; utilize departmental DLP, process guides, and policies to ensure staff are utilizing resources provided.Other Duties as Assigned.Qualification Requirements
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Required
Position requires constant mental alertness, attention to detail, and a high degree of accuracy required in completing all assignments. Strong problem-solving skills. Smart, driven, exceptional work ethic. Must be able to: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 a thorough understanding of physician billing, accounts receivable follow-up, charge entry, cash posting, eligibility and benefits, authorization, referrals, transaction review, adjustment posting, etc.Have a proven track record of working in a QA analyst role.Have proven experience utilizing payer portals including but not limited to: Availity, NaviNet, Change, Waystar, and others.Be accustomed to working in a productivity/quality-based environment.Have the ability to efficiently work in a remote environment, including good time management skills and timely communication with co-workers.
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