Miami, Florida
Billing Quality Assurance Analyst Job Opening in Miami, Florida - Billing Quality Assurance Analyst
CareCloud is transforming the healthcare experience with the industry?s most modern, flexible and powerful cloud-based platform to help providers maximize the efficiency and effectiveness of their practices while connecting and collaborating directly with patients in support of better care. CareCloud solutions include revenue cycle management, practice management, electronic health records, advanced billing rules, and analytics.
CareCloud is a high-growth company serving ambulatory medical practices of all sizes. We evolve quickly and innovate constantly. We need a proven professional to bring that innovative spirit to the way we train our clients to use our beautiful, intuitive software.
Job Description:
The Billing Quality Assurance Analyst role serves as an analyst for all billing performed by both internal and offshore billing teams. The primary objective of the Billing Workflow Coordinator is to use knowledge to provide a second level review of codes assigned to medical diagnoses and clinical procedures, ensuring that medical billing conforms to legal and procedural requirements. Reviews develops, and/or modifies client procedures, systems, and protocols to achieve and maintain billing requirements and compliance standards.
General Areas of Responsibility:
Conducts and coordinates routine scheduled audits of physician documentation involved with professional fee billing, for accuracy of coding and physician physical presence.
Conducts exit interviews, detailing audit results, with individual clinical department chairpersons and/or physician and billing representatives.
Prepares various reports, including audit summary reports for individual department practice managers, and broad summary reports for the Director of Coding
Maintains all records and data logs
Perform GAP Analysis reporting
Educating staff on coding changes and updates
Assisting staff with claim denials (bundled procedures, LCD, NCD issues)
Diagnosis & procedural coding
Other duties as assigned
Required Knowledge, Skills and Abilities:
Extensive knowledge in CPT coding
Extensive knowledge in ICD-9-CM & ICD-10CM
Experience with Coding Compliance, GAP analysis, auditing
Excellent knowledge in
Excellent communication skills
Ability to work independently or as part of a team
Approachable, confident, assertive and hard working
Problem-solving skills
Analytical and organized and an ability to interpret complex information and to use own judgment in finalizing reports
Experience of presenting highly complex information to audiences with varied levels of understanding
Qualifications
CPC/RHIT Certification
CCDI or equivalent experience
CHA/CPMA recommended
Minimum 2+ years auditing experience
EEO Statement:
CareCloud is an equal employment opportunity employer.
ADA Statement:
Reasonable accommodations may be made to enable individuals with disabilities to perform essential job functions.
Other Duties:
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Job Type: Full-time
Job Location:
Miami, FL
Required education:
High school or equivalent
Required experience:
Auditing: 2 years
CPT Coding: 2 years
ICD-9-CM & ICD-10CM: 2 years
|
