Quality Control Auditor (Remote)

North American Partners in Anesthesia (NAPA); Fort Lauderdale (FL); Remote; USD 40,000 - 56,000; Full time

Job summary

A leading healthcare organization is seeking a Quality Auditor to ensure accuracy in billing and insurance processes. The ideal candidate will manage work queues and perform insurance verification, requiring a high school diploma and relevant experience. Benefits include a comprehensive package with paid time off, insurance coverage, and professional development opportunities.

Benefits

Paid Time Off

Health, life, vision, and dental insurance

Flexible Spending Accounts / Health Savings Accounts

401(k) plan

Leadership and professional development opportunities

Qualifications

• Experience in medical insurance verification or data entry.
• Knowledge of billing procedures and insurance plans.
• Ability to manage multiple requests and work collaboratively.

Responsibilities

• Manage and process assigned work queues.
• Ensure insurance information is accurate and properly entered.
• Review and resolve insurance-related discrepancies.

Skills

Prioritization

Data Entry

Insurance Verification

Collaboration

Flexibility

Education

High School Diploma or equivalent

Tools

Electronic Medical Records (EMR/EHR)

Excel

Word

Outlook

Job description

To work on registration and audit daily work done by offshore Data Entry teams. Ensure there is no delay with charges and that the charges are being posted correctly within the billing system. Determine if insurance received from facility is accurate and eligible for our Anesthesia services and update accordingly.

Responsibilities and Duties :

• Manage and process assigned work queues in a timely and productive manner with high quality.
• Send requests for new surgeons to be added to the billing system
• Recommend vendor education based on errors found while resolving work queue tasks
• Review and correct insurance-related payor codes
• Determine eligibility, insurance product and plan types for patient accounts utilizing, Availity, payer websites, contact with payers, and hospital's EMR.
• Ensures all insurance information is obtained and entered in the system in an accurate manner.
• Identify discrepancies in patient insurance information and corrects the insurance information within the billing system timely.
• Reviews medical records, patient demographic sheets / face sheets and EMR systems. Make changes to the patient's account based on information reviewed

Qualifications :

• High School Diploma or equivalent required.
• Ability to prioritize and manage multiple requests and respond within designated timeframe.

DESIRED / PREFERRED QUALIFICATIONS :

• 1+ years of experience with insurance verification / Data Entry in the Medical field
• Has a basic working knowledge of billing procedures, insurance reimbursement and guidelines preferably in a medical or anesthesia setting.
• Has basic knowledge of insurance plans along with understanding guidelines for Medicare / Medicaid, government plans, HMOs, and PPOs.
• One-year prior electronic medical records experience required (EMR / EHR)
• Beginner Excel, Word, and Outlook skills
• Team player that develops strong collaborative working relationships with internal team and can effectively engage and ability to build consensus among cross-functional teams.
• Work requires focus, flexibility, and the ability to adapt to changing work situations.
• Ability to maintain department benchmark for quality and productivity.

Total Rewards

• Generous benefits package, including :
• Paid Time Off
• Health, life, vision, dental, disability, and AD&D insurance
• Flexible Spending Accounts / Health Savings Accounts
• 401(k)
• Leadership and professional development opportunities

EEO Statement

North American Partners in Anesthesia is an equal opportunity employer.

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Quality Auditor • Fort Lauderdale, FL, US