Accounts Receivable Quality Assurance Auditor

This is a fully remote position, open to applicants in California.

📋 Description

• Review the daily tasks performed by billing personnel, including claim submissions, follow-up actions, and collection efforts.

• Evaluate account documentation, actions taken, and billing results within the billing system to ensure they are accurate, complete, and compliant.

• Detect errors, inconsistencies, and trends that may influence reimbursement, operational efficiency, or adherence to regulations.

• Deliver comprehensive audit findings, constructive feedback, and recommendations to billing staff and management.

• Oversee, address, and audit special projects and initiatives, including credit card chargebacks, urgent payer follow-ups, and AB75.

• Collaborate with team leads, supervisors, and management to develop, implement, and enhance policies, procedures, and workflows based on audit findings.

• Assist in training and educating staff on documentation standards, payer requirements, billing procedures, and industry best practices.

• Engage in quality assurance efforts and prepare reports for management summarizing audit findings, performance trends, and opportunities for improvement.

• Keep up-to-date with industry regulations, payer policies, and updates to billing software pertinent to medical billing and accounts receivable.

• Facilitate internal and external audit requests by collecting documentation, conducting reviews, and addressing audit inquiries.

• Execute manual tasks within Cross Workflow, including AR Support Requests and AR Follow-Up Requests.

• Handle high-priority Patient Services emails concerning invoices that involve legal representation and time-sensitive deadlines.

• Conduct compliance audits as assigned or requested.

⛳️ Requirements

• Capability to thrive in a fast-paced environment while maintaining accuracy and concentration.

• Strong organizational abilities to ensure deadlines are consistently met.

• Profound knowledge of medical billing and accounts receivable processes, including claim lifecycle, denials, and payer regulations.

• Proficient in utilizing billing software and electronic health record (EHR) systems.

• High level of attention to detail and accuracy when reviewing documentation and financial records.

• Analytical skills with the capacity to identify patterns, inconsistencies, and areas needing improvement.

• Understanding of and compliance with HIPAA and other government and healthcare industry regulations.

• Strong written and verbal communication abilities to deliver constructive feedback and report findings effectively.

• Ability to work independently, manage various tasks, and prioritize responsibilities efficiently.

• Extensive knowledge of insurance guidelines, including Medicare and other government payers, as well as private, self-insurance, and managed-care plans.

• Familiarity with auditing techniques and principles within a healthcare revenue cycle context.

• Proficient in MS Office applications including Outlook, Word, and Excel.

• Excellent verbal and written communication skills.

• Exceptional attention to detail and time management abilities.

• Strong customer service skills.

• High School Diploma.

• At least 3-4 years of experience in revenue cycle management.

🏝️ Benefits

• Comprehensive health benefits package.

• Competitive salary and performance-based incentives.

• Opportunities for professional development and career advancement.

• Supportive work environment fostering teamwork and collaboration.