QA Auditor Level I

MedRisk LLC; West Conshohocken (PA); On-site; USD 25,000 - 39,000; Full time

Job summary

MedRisk LLC is seeking a QA Auditor I to join the team in Conshohocken, PA. The role focuses on auditing Workers' Compensation bills re-priced through Medata or Bridge and ensuring high-quality data before mailing.

The candidate will monitor backlogs, meet audit deadlines, and contribute to continuous improvement with cross-functional teams. Strong organization, detail orientation, and MS Office proficiency are essential.

Qualifications

• Detail-oriented with strong organizational, time management and problem-solving abilities.
• Knowledge of Workers' Compensation billing procedures including CPT Coding, ICD-10, and HCPC.
• Proficient in MS Office tools (Word, Excel, Outlook).
• Ability to multi-task, adapt quickly to change and follow projects through completion.

Responsibilities

• Audit all Workers' Compensation bills re-priced through Medata or Bridge.
• Meet/exceed audit productivity and quality standards to maintain integrity of the claim/bill.
• Maintain and report backlogs; ensure QA of claims within deadlines.
• Determine error sources and enter audits accurately; document in QA log.

Skills

Detail-oriented

Organizational skills

Time management

Problem solving

MS Office (Word, Excel, Outlook)

Education

Knowledge of Workers' Compensation billing procedures

Tools

MS Word

MS Excel

MS Outlook

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