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Healthcare Accounts Receivable QA Auditor

extra holidays - extra parental leave
Remote: 
Full Remote
Salary: 
33 - 44K yearly
Experience: 
Senior (5-10 years)
Work from: 
Maryland (USA), United States

Offer summary

Qualifications:

Associates degree or equivalent education, 4-8 years experience in medical billing, Knowledge of denial trends and AR processes, Proficient in Excel and PowerPoint.

Key responsabilities:

  • Audit claims and identify denial trends
  • Conduct root cause analysis on denials
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Cognizant Large https://www.cognizant.com
10001 Employees
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Job description

Accounts Receivable Quality Assurance Analyst

In this role, the successful candidate should have thorough working knowledge on resolving physician claim denials. This position will be responsible for auditing a sample of claims worked by the team from the Accounts Receivable report. Candidate should be able to identify denial trends, analyze the root cause of the physician payer denials, also should be familiar with procedures impacted by National Correct Coding Initiative Edits (NCCI), technical payer policies, appeal documentation and resolution.

AR Related Skills

  • Working knowledge of various RARC and CARC codes, and how to work them to resolution for reimbursement.
  • Demonstrates knowledge and expertise in state/federal billing guidelines, reimbursement methodologies, and payer policies.
  • Makes recommendations for additions/revisions/deletions to work queues and claim edits to improve efficiency to reduce denials and underpayments.
  • Tracks and trends claim denials and underpayments to identify initiatives for payer, process or technology improvement plans.

Quality Assurance Related Skills

  • Be able to create Error Parameters based on the Client guidelines.
  • Be able to conduct Root cause analysis on all errors & publish the findings,
  • Strong Communication Skills- both verbal & written, to be able to provide clear and effective Feedback on top errors and coach the team members on the corrective and preventive actions.
  • Should be comfortable speaking in a group setting as well as individually, on a daily, weekly, and monthly frequency.
  • Should be able to confidently present Error trends to the client, as well as any queries for clarification before the client.

Technical Skills (Must-Have)

  • Participate in monthly calibration sessions with operations & clients, discuss audit sheets, changes on need basis with the operations & clients and
  • Analytical & Problem-solving skills
  • Strong Excel skills to combine daily audits, summarize the error trends, track associate wise Quality performance. Power Point skills for creating presentations would be a bonus.

Domain Knowledge: 4-8 Yrs. Work experience in a Hospital/Doctor’s Office setting/Medical Billing Company, with specific working knowledge on resolving Physician claims.

Salary And Other Compensation

Applications will be accepted until 11/30/2024

The hourly rate for this position is between $17.00-23.00 per hour, depending on experience and other qualifications of the successful candidate.

This position is also eligible for Cognizant’s discretionary annual incentive program, based on performance and subject to the terms of Cognizant’s applicable plans.

Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:

  • Medical/Dental/Vision/Life Insurance
  • Paid holidays plus Paid Time Off
  • 401(k) plan and contributions
  • Long-term/Short-term Disability
  • Paid Parental Leave
  • Employee Stock Purchase Plan

Disclaimer: The hourly rate, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.

Education and/or Experience Associates degree or equivalent from two-year College or technical school or six months to one-year related experience and/or training or equivalent combination of education and experience.

Cognizant will only consider applicants for this position whom are legally authorized to work in the United States without requiring company sponsorship now or at any time in the future.

What is in it for you? Well, at Cognizant, we offer a competitive compensation package including excellent benefits such as insurance (available day 1 of employment), great work life balance, 401k with matching component, and many other benefits.

An inclusive environment embracing diversity: for the second time, Cognizant has been named to the Forbes list of Best Employers for Diversity based on survey responses from its employees!

About Cognizant

Cognizant (Nasdaq: CTSH) engineers modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at www.cognizant.com or @cognizant.

Required profile

Experience

Level of experience: Senior (5-10 years)
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Quality Assurance
  • Microsoft Excel
  • Microsoft PowerPoint
  • Analytical Thinking
  • Communication
  • Coaching

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