Insurance QA Specialist

About Us: 

Meduit is a national leader in healthcare revenue cycle management, supporting hospitals and physician practices in 48 states. We focus on optimizing payments, allowing clients to focus on patient care, and pride ourselves on our core values: Integrity, Teamwork, Continuous Improvement, Client-Focused, and Results-Oriented. Learn more at www.meduitrcm.com. 

About the Role: 

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.

 

Key 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

 

Competencies:

Strong verbal and written communication skills, including public speaking and group facilitation

Ability to maintain a working knowledge of multiple systems and applications as assigned

Strong organizational, time management, and multitasking skills in a fast-paced environment

Detail oriented and self-motivated, with strong follow-up skills

Adaptable with the ability to shift priorities as needed

Ability to maintain confidentiality of patient, employee, and company information

Ability to understand and comply with organizational policies, procedures, and regulatory requirements

Required Qualifications: 

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. (you can test your speed here: https://speedtest.net/)

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)

 

Preferred Qualifications: 

​​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​

 
Employment eligibility: 

Must be legally authorized to work in the United States without sponsorship

As a condition of employment, a pre-employment background check will be conducted

At this time, we are unable to consider candidates residing in the state of New York for this position

What We Offer: 

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 

Meduit is an Equal Opportunity Employer. We do not discriminate based on any protected class and welcome applicants from all backgrounds, consistent with applicable laws. Employment is contingent upon successful completion of a background check, satisfactory references, and any required documentation. 

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position. 

​​#LI-DNI​

Equal Opportunity Employer
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