Job Description
Role Description
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.
- 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
- Access to a Secure and Private workspace
- Requirements
- 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
- 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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