Posted: Saturday, January 6, 2018 12:37 PM
Job DescriptionThe Quality Assurance Specialist, under immediate supervision, performs quality assessments on inbound and outbound calls of Customer Service Representatives in which the level of quality, as defined, is evaluated and scored. From time to time, the incumbent will also audits accounts and reviews and analyzes data and documentation to ensure compliance with company policies and procedures and government regulatory requirements. Judgements are made on routine matters of relatively small impact. The candidate/incumbent is somewhat familiar with fundamental quality assurance methods, concepts and practices. The Quality Assurance Specialist has knowledge of operational procedures and assists in identifying opportunities for process improvement. Quality Assurance Specialist usually reports to the department lead or supervisor. EDUCATION & WORK EXPERIENCE:High school diploma or equivalent. A minimum of 2 years previous work experience in healthcare insurance collections, self-pay collections and customer service in a call center setting or compliance and/or training. Must have an understanding of the basic healthcare revenue cycle operational processes such as insurance and patient billing and collections, Managed Care, Medicare, Medicaid and Commercial Practices. Experience in customer service in a call center setting is desirable. REQUIRED JOB KNOWLEDGE & SKILLS:Ability to learn/stay abreast of relevant policies and proceduresAbility to perform under pressure in a calm mannerAbility to work independentlyBasic math skillsComputer literate/able to use basic functions of a computerDetail oriented and well organizedExcellent customer service skillsExcellent verbal and written communication skillsFlexibleGood interpersonal and listening skillsGood problem solving skillsHas some knowledge of Quality Assurance methodologiesKnowledge of CUBSKnowledge of EOBs, CPT & ICD-9 & 10 codes, HCFAs, UB92s, HCPCS, DRGs and authorizations/referralsMicrosoft Office Suite (Word, Excel, PowerPoint, Outlook)Performs tasks with a high degree of accuracyPositive attitudeTeam player Core responsibilities include but are not limited to the items listed below:Assess quality of customer service by monitoring recorded inbound and outbound calls.Apply PAS quality standards in the Call Quality Assessment process.Record results of all Call Quality Assessments.Identify follow-up on poor quality outcomes.Audit accounts for timely and proper follow-up.Document results of account audits.Performs HIPAA audits to ensure compliance with current HIPAA policies.Assist with special projects.Performs other duties as assigned Company DescriptionWe work hard to make Acclara a great place to work, because our people are our greatest assets. We encourage employees to learn and develop through training, workshops, and professional opportunities to ultimately assume greater responsibilities and take on leadership roles as their skills and understanding of revenue cycle management solutions grows.
• Location: Austin
• Post ID: 28043567 austin