Quality Analyst, Contract Reimbursement Analysis

Job Posting Closing Date: Open until Filled

Where do you belong?

Your career is more than just a job, it's part of your life. Whether you’re a clinician, or non-clinical professional,  at USACS you'll feel a sense of connection working with clinicians and office staff who share your interests and values. We want you to love coming to work each day because you believe in what you do and the people with whom you work. We care about your success.

USACS also understands that location is important. We offer  career opportunities for clinicians and non-clinical support staff from New York to Hawaii and numerous points in between. Our supportive culture,  outstanding benefits and competitive compensation package is best in class.

Job Description

Location: Remote

ESSENTIAL JOB FUNCTIONS:      

• Performs quality audits for the CRA state and federal arbitration process, both for department staff and offshore vendors, to ensure completed tasks are meeting IDR policies, following known strategies and best practices, while using applicable resources appropriately.
• Recognizes coaching opportunities and works with department staff and offshore team members to develop necessary skills.
• Creates, updates, and maintains spreadsheets to track monthly audit information and report on quality results.
• Assists with developing and performing on-going training/support programs customized for new hire training as well as continuing education training for existing department staff and offshore team.
• Assists with managing updates to existing training materials and developing new resources by evaluating department needs.
• Researches payer and Independent Dispute Resolution Entity (“IDRE”) trends, making recommendations to improve IDR success rate and monitor success of strategy changes.
• Assists department director and manager with additional CRA team audits as needed.
• Performs and assists with other department duties as needed.

KNOWLEDGE, SKILLS AND ABILITIES:

• Demonstrates the ability to learn rapidly and adapt quickly to new processes and technology.
• Uses logic and analysis to solve problems and offers useful solutions appropriate for the situation at hand.
• Knowledge of medical insurance and its terminology.
• Knowledge of and skill in using personal computers and terminals in a Windows environment.
• Proficiency with external programs including Athena, OnBase, Intellicred, and web-based portals.
• Proficiency with Excel, Word, and Adobe.
• Ability to pay close attention to detail.
• Ability to identify, research and solve problems and discrepancies.
• Ability to communicate with coworkers, management, and third-party payers in a courteous and professional manner.
• Ability to maintain confidentiality.
• Ability to work effectively in a remote setting.
• Ability to work overtime when needed.

EDUCATION AND EXPERIENCE: 

• High school diploma or equivalent; post-secondary course work preferred.
• At least one year of experience in payer contracting or RCM related roles.

PHYSICAL DEMANDS:

• While performing the duties of this job, the employee is regularly required to sit for prolonged periods. and occasionally walk, stand, bend, stoop, and lift, up to 15 pounds.
• Required to have close visual acuity to perform job.

Hourly Rate: $21.59-$39.94