Insurance QA Specialist
Med A/Rx
•$20•Remote
About The Position
The Insurance Quality Assurance (QA) Specialist audits and reviews account representatives’ work to ensure accuracy, compliance with company policies, and adherence to regulatory and client specific requirements. The role supports revenue cycle performance through data analysis, trend identification, and actionable feedback to Operations.
Requirements
- Minimum of 3-5 years of experience in revenue cycle management, billing, coding, or quality assurance within a healthcare setting
- Internal candidates: minimum of 1 year with Meduit
- Experience with nationwide payors and regulations: Medicare, Medicaid, and commercial payor experience
- Proficiency with Microsoft Office
- Download speed of 30MB or higher & upload speed of 10MB or higher are REQUIRED.
- Access to a Secure and Private workspace (a space in which no one can hear or see you as you may have protected health information on your screen or you may say names, social security numbers or other PHI)
Nice To Haves
- Bachelor’s degree in Health Information Management, Healthcare Administration, and/or related field
- Certification as a Certified Professional Coder (CPC), Certified Coding Specialist (CCS), or similar credentials
- Systems Experience: Epic, Meditech, Cerner, & ECW
Responsibilities
- Conduct audits across multiple projects to assess account accuracy, documentation quality, billing and coding practices, and adherence to standard operating procedures and workflows
- Verify claims, validate data integrity, and evaluate compliance with regulatory and client specific guidelines specific guidelines
- Analyze audit results to identify error trends, discrepancies, and opportunities for improvement
- Document clear, accurate audit findings and recommendations, highlighting training needs and process improvement opportunities
- Provide reporting and feedback to Operations to support performance improvement and compliance
- Maintain strict confidentiality and security of patient and company information
- Meet established daily, weekly, and monthly productivity and quality targets
Benefits
- Comprehensive paid training
- Medical, dental, and vision insurance
- HSA and FSA available
- 401(k) with company match
- Paid Wellness Time and Holidays
- Employer paid life insurance and long-term disability
- Internal growth opportunities
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
