Quality Control Auditor (Remote)

NAPA Anesthesia; Town of Florida, Northern (NY, KY); Hybrid; USD 21,000 - 30,000; Full time

Benefits offered by this job

Paid Time Off

Health Insurance

Life Insurance

Vision Insurance

Dental Insurance

Disability Insurance

AD&D Insurance

FSAs/HSAs

401(k)

Professional development

Job summary

North American Partners in Anesthesia (NAPA) in Sunrise, FL is seeking an Insurance Verification Specialist to oversee daily data entry work and audit offshore teams. You will ensure charges post accurately and determine insurance eligibility for our anesthesia services.

Responsibilities include managing queues, reviewing payor codes, and updating patient enrollment in the billing system using Availity and the EMR.

Qualifications

• High School Diploma or equivalent is required.
• 1+ years of insurance verification/data entry experience in medical field.
• Basic knowledge of billing procedures and insurance guidelines.
• EMR/EHR experience recommended.

Responsibilities

• Manage and process assigned work queues promptly with high quality.
• Request new surgeons to be added to the billing system.
• Review insurance payor codes and ensure accuracy.
• Determine eligibility and plan types using Availity, payer sites, and EMR.
• Enter and update insurance information accurately in the system.
• Identify and correct discrepancies in patient insurance data.
• Review medical records and EMR data for patient accounts.
• Adjust patient accounts based on reviewed information.

Skills

Insurance verification

Data Entry

EMR/EHR

Billing procedures

Excel

Word

Outlook

Education

High School Diploma or equivalent

Tools

Excel

Word

Outlook

Job description

Sunrise,FL - USA Position Requirements Job Description Job Overview: 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. Moderate computer skills.

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

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. North American Partners in Anesthesia (NAPA) has evolved through more than 30 years to become a leader in anesthesia and perioperative services. Single specialty and clinician led, we remain committed to our mission of delivering exceptional patient experiences, every day. At NAPA, we cultivate leaders, promote work-life balance, and celebrate diversity. We know your success promotes our success, and we give you the tools and programs to achieve your goals. With flexibility, a collegial and collaborative environment, a wide range of market-leading benefits, and career opportunities from coast-to-coast, your future is waiting at NAPA.