Job Details

Billing Quality Assurance Analyst

Reliable Respiratory is a Durable Medical Equipment (DME) company that provides the highest quality service for patients needing respiratory, diabetes, urology, and maternity support. Equipment provided includes CPAPs, BiPAPs, AutoPAPs, nebulizers, oxygen equipment, ventilators, CGM devices, insulin pumps, and breast pumps.

Each patient is treated with professionalism, understanding, and attentive service. We care about our customers, work closely with the medical community, and have highly skilled staff ready to assist customers in receiving the best care possible.

The Billing Quality Assurance Analyst is responsible for supporting the Billing Department and ensures products and services meet established standards by conducting tests, analysis and quality control of all billing duties performed.

Duties and Responsibilities

• Responsible for conducting detailed audits of customer calls, payments, denials, and billing systems to ensure accuracy and adherence to SOPs
• Reviews patient records, billing codes and payment data to identify coding or submissions errors
• Identifies patterns and recurring errors from audit results to pinpoint areas for improvement
• Develops and implements audit plans and quality criteria to evaluate processes and procedures
• Prepare detailed reports on quality metrics and performance trends
• Ensures all billing practices adhere to relevant healthcare regulations (HIPAA) and industry best practices
• Stays updated on coding guidelines, payer requirements and regulatory changes to ensure compliance
• Recommends and drives modifications to operating practices and policies to eliminate quality gaps and improve efficiency
• Monitors team productivity and operational efficiency targets to ensure KPI's are met
• Complete ad-hoc project work as directed by your manager
• Assist in facilitating workload distribution relevant to specific department needs
• Other tasks and duties as require

Basic Qualifications

• 18 years of age or older
• Must be eligible to work in the United States and not require work authorization from us now or in the future
• Bachelor's Degree preferred

Required Skills

• Experience with completing quality control functions associated with billing
• Effective and professional verbal and written communication abilities
• Professional computer experience (especially Microsoft Office Suite)
• Ability to work in the Norwood office, as needed
• Ability to work independently to investigate and make decisions
• Ability to prioritize and complete work amidst interruptions in a busy work area
• Ability to comply with guidelines both internal and industry-imposed
• Ability to reconcile multiple shifting logistical factors for each appointment
• Strong attention to detail
• Bilingual in English and Spanish preferred

Competencies

• Computer Skills
• Interpersonal Skills
• Product Expertise
• Communication skills
• Results Driven
• Conflict Management
• Customer Service
• Organizational skills

Work Environment & Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• While performing the duties of this job, the employee is regularly required to communicate and convey information with the appropriate parties. The job requires assuming a stationary position for long periods of time
• This role routinely uses standard office equipment such as computers, phones, and printers/scanners

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

• This job operates in a professional office environment
• The noise level in the work environment is usually moderate to loud

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.