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Company Contact Info
Canton, OH 44718
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Quality Assurance Auditor
Alliance HealthCare Services • Canton, OH
Posted 2 months ago
We are seeking a full time Quality Assurance Auditor to help us ensure our medical coding is accurate and correct for medical billing purposes. Medical coding certification from AAPC or AHIMA is preferred.
Position is Monday through Friday, 8 am to 5 pm, and eligible for the following benefits:
- Medical/Dental/Life insurances
- 401k with company match
- Paid vacation/floating holidays/sick
The Quality Assurance Auditor ensures that services which are billed retail have compliant documents that support accurate coding, helping to support the submission of clean claims in an effort to increase reimbursement and decrease Days Sales/Services Outstanding (DSO) metrics.
Specific duties include, but are not limited to:
- Conducts reimbursement reviews based on denial information from insurance carriers. Performs quality assurance testing under the direction of a Retail Revenue Services Supervisor/ Manager, in order to ensure accuracy, timeliness, and compliance. Conducts regularly scheduled as well as random testing and audits.
- Analyzes data and utilizes business software to create compelling, informative and persuasive communications to Operations teams and sites.
- Develops and maintains workflow documentation for system and work processes related to billing/collections and reimbursement.
- Works with the collections team to create first/second level appeals.
- Reviews data to ensure A/R and DSO are at appropriate levels.
- Reviews work results, logs, forms, reports and other documents to analyze and track department performance. Resolves workflow issues and/or makes recommendations to Retail Revenue Services Supervisor/Manager to maximize productivity and workflow while ensuring accuracy, timeliness, and compliance.
- Executes special projects as assigned by the RRS Supervisor/Manager.
- High School Diploma or equivalent experience required.
- Previously worked in a revenue cycle management environment focusing on A/R resolution required.
- AAPC or AHIMA certified not required but a plus.