Remote Quality Assurance Analyst - Medical Billing

Crossroads Treatment Centers • Greenville, SC

1d • Remote

About The Position

Crossroads Treatment Centers is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Since 2005, Crossroads has been at the forefront of treating patients with opioid use disorder. Crossroads is a family of professionals dedicated to providing the most accessible, highest quality, evidence-based medication assisted treatment (MAT) options to combat the growing opioid epidemic and helping people with opioid use disorder start their path to recovery. This comprehensive approach to treatment, the gold standard in care for opioid use disorder, has been shown to prevent more deaths from overdose and lead to long-term recovery. We are committed to bringing critical services to communities across the U.S. to improve access to treatment for over 26,500 patients. Our clinics are all outpatient and office-based, with clinics in Georgia, Kentucky, New Jersey, North and South Carolina, Pennsylvania, Tennessee, Texas, and Virginia. As an equal opportunity employer, we celebrate diversity and are committed to an inclusive environment for all employees and patients. Day in the Life of a Quality Assurance Analyst Performs 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. Contributes to development, implementation and maintains 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 productivity and quality assurance with 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 department Communicate professionally (in all forms) with payer resources to include websites/payer portals, e- mail, telephone, staff members, etc. Assists 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 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; utilizes departmental DLP, process guides, policies to ensure staff are utilizing resources provided Other Duties as Assigned Education and Experience 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

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

Responsibilities

• Performs 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.
• Contributes to development, implementation and maintains 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 productivity and quality assurance with 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 department
• Communicate professionally (in all forms) with payer resources to include websites/payer portals, e- mail, telephone, staff members, etc.
• Assists 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
• 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; utilizes departmental DLP, process guides, policies to ensure staff are utilizing resources provided
• Other Duties as Assigned

Benefits

• Have a daily impact on many lives.
• Excellent training if you are new to this field.
• 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.
• Opportunity to save lives everyday!
• Benefits Package 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

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 1-10 employees