Accounts Receivable Quality Assurance Auditor

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

📋 Description

• Review and audit daily work performed by billing personnel, encompassing claim submissions, follow-up actions, and collection initiatives.

• Examine account documentation, actions executed, and billing results within the billing system for precision, completeness, and adherence to compliance standards.

• Detect errors, inconsistencies, and trends that impact reimbursement, operational efficiency, or compliance with regulations.

• Deliver audit findings, insights, and suggestions to billing staff and management.

• Oversee, address, and audit special projects and programs, which include credit card chargebacks, urgent payer follow-up, and AB75.

• Partner with team leaders, supervisors, and managers to enhance policies, procedures, and workflows.

• Aid in training staff on documentation standards, payer mandates, billing practices, and industry best practices.

• Engage in quality assurance projects and compile reports for management.

• Stay updated on industry regulations, payer policies, and enhancements in billing software.

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

• Carry out manual tasks within Cross Workflow, which include AR Support Requests and AR Follow-Up Requests.

• Handle high-priority Patient Services emails related to invoices that involve legal representation and urgent deadlines.

• Perform compliance audits as assigned or requested.

⛳️ Requirements

• Capability to thrive in a fast-paced environment while ensuring precision and concentration.

• Strong organizational abilities to meet deadlines efficiently.

• In-depth knowledge of medical billing and accounts receivable processes, including the claim lifecycle, denials, and payer regulations.

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

• Exceptional attention to detail and accuracy when reviewing documentation and financial records.

• Analytical capabilities to identify patterns, discrepancies, and opportunities for enhancement.

• Understanding and compliance with HIPAA and other governmental and healthcare industry regulations.

• Strong written and verbal communication skills to provide constructive feedback and document findings.

• Ability to work independently, manage multiple tasks, and effectively prioritize responsibilities.

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

• Familiarity with auditing techniques and principles in a healthcare revenue cycle environment.

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

• Excellent verbal and written communication abilities.

• Remarkable attention to detail and time management skills.

• Outstanding customer service capabilities.

• High School Diploma.

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

🏝️ Benefits

• Comprehensive health insurance plans.

• Opportunities for professional development and training.

• Flexible work schedules.

• Generous paid time off policies.

• Retirement savings plan with employer contributions.