Quality Control Auditor

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

📋 Description

• Oversee the registration process and audit daily tasks completed by offshore Data Entry teams.

• Ensure that charges are accurately posted in the billing system without any delays.

• Assess the accuracy and eligibility of insurance received from facilities for anesthesia services, and make updates as needed.

• Manage and process assigned work queues efficiently, maintaining high quality and productivity.

• Submit requests for the inclusion of new surgeons in the billing system.

• Suggest vendor training based on errors discovered while handling work queue tasks.

• Review and amend insurance-related payor codes.

• Verify eligibility, insurance products, and plan types for patient accounts using Availity, payer websites, payer contacts, and hospital EMR systems.

• Ensure accurate collection and entry of insurance information.

• Identify and promptly rectify discrepancies in patient insurance details within the billing system.

• Examine medical records, patient demographic sheets/face sheets, and EMR systems; update patient accounts based on findings.

⛳️ Requirements

• High School Diploma or equivalent is mandatory.

• Capable of prioritizing and managing multiple requests while responding within the specified timeframe.

• Intermediate computer skills are necessary.

• A minimum of 1 year of experience in insurance verification/Data Entry within the Medical industry.

• Fundamental understanding of billing procedures, insurance reimbursement, and guidelines, preferably in a medical or anesthesia context.

• Basic knowledge of various insurance plans, including Medicare/Medicaid, government plans, HMOs, and PPOs.

• At least one year of experience with electronic medical records (EMR/EHR) is required.

• Proficiency in beginner-level Excel, Word, and Outlook.

• Strong ability to foster collaborative relationships and engage effectively with cross-functional teams.

• Flexibility to adapt to changing work environments.

• Commitment to maintaining departmental benchmarks for quality and productivity.

🏝️ Benefits

• Paid Time Off

• Health insurance

• Life insurance

• Vision insurance

• Dental insurance

• Disability insurance

• AD&D insurance

• Flexible Spending Accounts

• Health Savings Accounts

• 401(k)

• Opportunities for leadership and professional development