Medicaid Eligibility QA Specialist — Remote

HCA Healthcare, Inc.; Nashville (TN); Remote; USD 55,000 - 75,000; Full time

Benefits offered by this job

Comprehensive benefits

Wellbeing support

Time away from work

401(k) Plan with 100% match on 3% to 9

Education support

Fertility and family building

Job summary

Parallon is seeking a Medicaid Quality Eligibility Specialist to support Medicaid eligibility operations on a remote basis. You will perform QA, analyze data to support decision-making, and document QA steps for audit trails across multiple departments.

Requirements include a minimum of 3 years in Medicaid Eligibility and proficiency with Microsoft Office, especially Excel and Word. A reliable home-office setup with high-speed internet is required to maximize revenue and improve processes within

Qualifications

• Minimum of 3 years’ experience within Medicaid Eligibility, preferably as both a hospital-based screener and an application processor.
• Experience with standard suite of Microsoft office software products.
• Intermediate to advanced proficiency with Excel and Word.
• Work from home roles require employees must have high speed internet 60 MB download and 10 MB upload.

Responsibilities

• Perform quality assurance activities for Medicaid eligibility operations to ensure that work efforts satisfactorily meet customer requirements in a systematic, reliable fashion, effectively using systems to do so.
• Perform analytical assessments of data and assist the management team in using the data for decision‑making purposes.
• Maintain prompt and accurate documentation outlining all steps of the QA program that have been taken in individual organized files.
• Audit the assigned number of accounts per day following a set schedule. Forms will be completed and submitted within required timelines.
• Work independently with various departments to ensure revenue is maximized.
• Maintain reports that are indicative of process improvement within departments while promoting a positive presence in improving these processes.
• Make recommendations based on assessments that improve production and quality.
• Ability to multi-task to ensure day-to-day work is complete as well as assigned projects.
• Coordinate QA findings with appropriate departments, internal or external, and ensure that necessary follow up is done to resolve any negative results.
• Provide documented results and process improvement to Director for departments not meeting company/client standards.
• Perform special projects or other activities as assigned. Establish and maintain constructive working relationships with coworkers, supervisors, managers and executives, as well as external clients and other external business contacts.

Tools

Microsoft Office

Excel

Word

Job description

Parallon is seeking a Medicaid Quality Eligibility Specialist to support Medicaid eligibility operations on a remote basis. You will perform QA, analyze data to support decision-making, and document QA steps for audit trails across multiple departments.

Requirements include a minimum of 3 years in Medicaid Eligibility and proficiency with Microsoft Office, especially Excel and Word. A reliable home-office setup with high-speed internet is required to maximize revenue and improve processes within