Quality Control Auditor (Remote)

Posted 16 Days Ago
Be an Early Applicant
Hiring Remotely in Corporation, Mowhan, County Armagh, Northern Ireland, GBR
In-Office or Remote
Entry level
Healthtech • Insurance • Professional Services • Consulting
The Role
Audit and correct insurance and billing data entered by offshore teams. Verify eligibility, payor codes, and insurance details using Availity, payer sites, and EMR; correct records, request surgeon additions, and recommend vendor education to improve quality and productivity.
Summary Generated by Built In
Sunrise,FL - USA

Position Requirements

Job Overview:

To work on registration and audit daily work done by offshore Data Entry teams. Ensure there is no delay with charges and that the charges are being posted correctly within the billing system. Determine if insurance received from facility is accurate and eligible for our Anesthesia services and update accordingly.

Responsibilities and Duties:

  • Manage and process assigned work queues in a timely and productive manner with high quality.

  • Send requests for new surgeons to be added to the billing system

  • Recommend vendor education based on errors found while resolving work queue tasks

  • Review and correct insurance-related payor codes

  • Determine eligibility, insurance product and plan types for patient accounts utilizing, Availity, payer websites, contact with payers, and hospital’s EMR.

  • Ensures all insurance information is obtained and entered in the system in an accurate manner.

  • Identify discrepancies in patient insurance information and corrects the insurance information within the billing system timely.

  • Reviews medical records, patient demographic sheets/face sheets and EMR systems. Make changes to the patient's account based on information reviewed

Qualifications:

  • High School Diploma or equivalent required.

  • Ability to prioritize and manage multiple requests and respond within designated timeframe.

  • Moderate computer skills.

DESIRED/PREFERRED QUALIFICATIONS:

  • 1+ years of experience with insurance verification/Data Entry in the Medical field

  • Has a basic working knowledge of billing procedures, insurance reimbursement and guidelines preferably in a medical or anesthesia setting.

  • Has basic knowledge of insurance plans along with understanding guidelines for Medicare/Medicaid, government plans, HMOs, and PPOs.

  • One-year prior electronic medical records experience required (EMR/EHR)

  • Beginner Excel, Word, and Outlook skills

  • Team player that develops strong collaborative working relationships with internal team and can effectively engage and ability to build consensus among cross-functional teams.

  • Work requires focus, flexibility, and the ability to adapt to changing work situations.

  • Ability to maintain department benchmark for quality and productivity.

Total Rewards

  • Generous benefits package, including:

  • Paid Time Off

  • Health, life, vision, dental, disability, and AD&D insurance

  • Flexible Spending Accounts/Health Savings Accounts

  • 401(k)

  • Leadership and professional development opportunities

EEO Statement

North American Partners in Anesthesia is an equal opportunity employer.

Skills Required

  • High School Diploma or equivalent
  • Ability to prioritize and manage multiple requests and respond within designated timeframe
  • Moderate computer skills
  • One-year prior electronic medical records experience (EMR/EHR)
  • 1+ years of experience with insurance verification/Data Entry in the Medical field
  • Basic working knowledge of billing procedures, insurance reimbursement and guidelines (preferably medical or anesthesia)
  • Basic knowledge of insurance plans and Medicare/Medicaid, government plans, HMOs, and PPOs
  • Beginner Microsoft Excel, Word, and Outlook skills
  • Team player with ability to build consensus across cross-functional teams
  • Ability to maintain department benchmark for quality and productivity
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The Company
HQ: Sunrise, FL
6,000 Employees
Year Founded: 1986

What We Do

North American Partners in Anesthesia (NAPA) is a leading clinician-led anesthesia and perioperative management company that provides clinical care and operational solutions to hospitals and healthcare facilities nationwide.

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