Offer summary

Qualifications:

Bachelor’s Degree in Business, Social Services, Public Administration, or a related field., 3 – 5 years of experience in health care, social services, or a related industry., Strong communication, written, interpersonal, and organizational skills are essential., Proficiency in Microsoft Word, Excel, PowerPoint, and Outlook is required..

Key responsabilities:

Facilitate and assure compliance of in-home care service billing with Medicaid and other requirements.

Conduct billing audits and respond to requests from payers by reviewing records and documentation.

Educate branch leadership and staff on regulatory and contract requirements.

Oversee external agency audit processes and monitor corrective action execution.

Job description

POSITION SUMMARY: Reporting to the Vice President of Quality Assurance, the Regional Quality Assurance Manager is responsible for facilitating and assuring in home care service billing is compliant with applicable Medicaid, Medicaid waiver, MCO, and other licensure and contractual requirements throughout all Addus personal care locations.This is remote position and the person will rarely be expected to travel. This position will primarily focus on billing audits.

>> We offer our team the best

Medical, Dental and Vision Benefits
Continued Education
PTO Plan
Retirement Planning
Life Insurance
Employee discounts
Company matched 401K

Essential Duties

Investigate and respond to requests for billing audits and recoupments from payers by reviewing records and documentation.
Develop, review, revise and implement standardized state specific policies, procedures and work processes that comply with Medicaid and other regulatory/contractual payer agreements
Educate branch leadership and staff on state regulatory and contract requirements.
Perform desktop audits and monitoring to assess branch level compliance with applicable rules and regulations.
Oversee and support external agency audit processes including audit preparation, deficiency remediation and corrective action planning.
Monitor corrective action execution and drive accountability.
Drive operational compliance and quality outcomes.
Report internal and external audit findings at all levels including branch, regional and senior leadership.
Facilitate investigation, reporting and resolution of incidents and complaints related to billing practices.
Performs other duties as assigned

Performance Responsibilities

Maintain positive internal and external customer service relationships
Maintains open lines of communication
Plans and organizes work effectively and ensures its completion
Meets all productivity requirements
Demonstrates team behavior and promotes a team-oriented environment
Actively participates in Continuous Quality Improvement
Represents the organization professionally at all times

Position Requirements & Competencies

Bachelor’s Degree in Business, Social Services, Public Administration, or a related field of study
3 – 5 years of experience in health care, social services or a related industry
Audit experience is strongly preferred
Some experience in a large, fast-paced, results-driven, multi-site organization
Must possess strong communication, written, interpersonal and organizational skills
Proficiency in using Microsoft Word, Excel, PowerPoint and Outlook, required.
Position may work remotely.
Must be self-confident, thorough, and prompt in completing assignments and projects
Passionate, energetic, tenacious and resolute, with a high sense of urgency and a strong drive to produce results

To apply via text, text 8133 to (334) 518-4376

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