Quality Analyst, Contract Reimbursement Analysis jobs in United States
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US Acute Care Solutions · 9 hours ago

Quality Analyst, Contract Reimbursement Analysis

US Acute Care Solutions is dedicated to fostering a supportive culture for both clinicians and non-clinical professionals. The Quality Analyst is responsible for performing quality and training audits, assisting with training content, and collaborating with the Contract Reimbursement Analysis team to implement best practices.

Health CareHospitalMedical

Responsibilities

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

Qualification

Quality auditsMedical insurance knowledgeExcel proficiencyAthena proficiencyOnBase proficiencyIntellicred proficiencyWindows environmentProblem-solvingAttention to detailCommunication skillsConfidentiality

Required

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

Benefits

Best in class benefit programs with a wide array of options

Company

US Acute Care Solutions

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US Acute Care Solutions (USACS) is committed to protecting and continually improving the quality of patient care.

Funding

Current Stage
Late Stage
Total Funding
$470.5M
Key Investors
Apollo
2021-02-09Private Equity· $470M
2016-01-24Acquired
2014-09-10Debt Financing· $0.5M

Leadership Team

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Amer Aldeen
Chief Medical Officer
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Matthew Patlovany
President & Chief Clinical Officer
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Company data provided by crunchbase