QA Auditor Level I

Medrisk Llc; Conshohocken (Montgomery County); On-site; USD 42,000 - 64,000; Full time

Job summary

Medrisk Llc in Conshohocken, PA is seeking a detail‑oriented QA Auditor I to join the Print Bridge workflow. The role is based in our Conshohocken office, 9:00 am to 5:00 pm, five days a week, with a focus on auditing workers' compensation bills re-priced through Medata or Bridge and ensuring accuracy before mailing.

You will identify trends, report backlogs, perform focused audits, and participate in ongoing quality improvement with the QA and CDT teams, while maintaining HIPAA compliance and

Qualifications

• Detail-oriented with strong organizational, time management and problem-solving abilities.
• Preferred extensive knowledge of Workers Compensation billing procedures including CPT/ICD-10/HCPC knowledge.
• Strong organizational, time management and multi-tasking abilities.
• Ability to manage multiple priorities, maintain confidentiality, and be courteous and helpful.
• Basic understanding of HIPAA policies and procedures.
• Ability to multi-task and adapt quickly to change while following projects to completion.
• MS Office: Word, Excel, Outlook experience.

Responsibilities

• Audit all Workers Compensation bills re-priced through Medata or Bridge.
• Meet or exceed audit productivity and quality standards.
• Maintain and report backlogs, ensuring QA of claims within dates.
• Determine error sources and document audit entries in QA logs.
• Interpret MedRisk contracts and HIPAA compliance requirements.
• Review error trends and participate in continuous improvement with QA/CDT teams.
• Provide one-on-one training and participate in QA meetings.
• Perform focused audits on varying data types.
• Complete other clerical duties as assigned.
• Lead by example with promptness and adherence to policies.

Skills

Detail‑oriented

Strong organizational skills

Time management

Problem-solving

MS Office experience

Tools

Medata

Bridge

Excel

Job description

If you are unable to complete this application due to a disability, contact this employer to ask for an accommodation or an alternative application process.

***This position will be in our Conshohocken, PA office 5 days a week, hours 9:00 am to 5:00 pm.***

Position Summary

• The QA Team audits critical fields on all provider HCFAs & UBs against re-priced MedRisk Generated EOBs or MedRisk Generated HCFAS before mailing.
• Trends are observed, identifying key systematic issues.
• QA team offers above standard quality on all bills before mailed.
• Confirming accuracy of billing data, routinely interacts with medata application for re-pricing incorrect bills.

Primary Duties & Responsibilities

• Audit all Workers Compensation bills re-priced through “Medata or Bridge”.
• Meet/exceed audit productivity and quality standards to maintain the integrity of the claim/bill.
• Maintain and report individual and team claim/bill backlogs, ensuring that all claims are QA’d within printed receive dates, audited within objective 2 days TAT goal.
• Determine error sources and accurate entry of claim audits, document with accuracy in QA Printing Production Excel log kept on Folks2 drive
• Interpret and understand MedRisk carrier contracts “CQ” and basic knowledge of state guidelines compliance, and HIPPA regulations.
• Review error trend reports and participate in rebuttal process for continuous improvement; providing feedback to Quality Assurance and CDT teams.
• Provide one-on-one training as needed with associates and actively participate in Quality Assurance Team meetings.
• Perform focused audits, working with varying types of data.
• Complete other clerical or support duties as assigned.
• Lead by example, demonstrate good promptness and adhere to company policies for yearly attendance.

Qualifications

• Detail-oriented with strong organizational, time management and problem-solving abilities.
• Preferred extensive knowledge of generalWorkers Compensation billing procedures including knowledge of CPT Coding, ICD-10, and HCPC
• Strong organizational, time management and project management skills with multi-tasking abilities.
• Manage multiple priorities, maintain confidentiality, and display a courteous, patient, and helpful attitude toward employees.
• Basic understanding of HIPPA policies and procedures.
• Ability to multi-task, adapt quickly to change and follow projects through completion
• MS Office Products; Word, Excel and Outlook experience

Competencies (choose at least 4)

Attachments (1)

Job Description_QA Auditor I - Print Bridge Clients.docx