The Quality Assurance Coordinator is responsible for working with all appropriate parties to proactively identify and resolve provider relations and regulatory related matters pertaining to Independent Diagnostic Testing Facility (IDTF) enrollment. This position will work closely with organization entity operators and Revenue Cycle Management (RCM) team to ensure that quality assurance activities occur as required and works with Directors of Administration to coordinate associated site visit document requirements. This position also helps to coordinate department activities and ensures all organizational credentialing activities are processed accurately, in a timely manner and in accordance with CMS standards and established guidelines.

TASKS AND RESPONSIBILITIES:

• Key liaison between entity operators and the Provider Contracting & Enrollment team
• Conducts virtual IDTF enrollment reviews. Gathers, maintains, and reports pertinent information to ensure accurate IDTF related reporting.
• May review, complete and submit provider enrollment and other applications as needed
• Will provide assistance with complex enrollment needs
• Reviews provider updates and informs management of changes
• Collaborates with the legal, tax, Directors of Administration, and other departments to obtain and or ensure maintenance of certifications, licenses or other documents necessary for compliance with government payer credentialing and or initial or ongoing enrollment requirements
• Researches and analyzes complex issues. Will function as a subject matter expert to assist with claims issues related to practitioner or group enrollment and identifies and communicates opportunities for process improvements.
• Ensures that all payer files are maintained in accordance with company policy
• Manages system tracking mechanisms to ensure accurate reporting of enrollment data
• Maintains all master files related to government carrier guidelines, pricing, diagnosis, and other data as needed
• Maintains Electronic Funds Transfer (EFT), Electronic Remittance Advice (ERA), Electronic Claims Submission and other government related carrier processing applications
• Creates and submits a weekly log to update management on projects/issues
• Completes all reports according to schedule
• Identifies and communicates operational process improvement to achieve maximum efficiency, accuracy, and data integrity.
• Ensures department response to verbal and written internal or external customer inquiries within policy and procedure timeline
• Addresses problems as they occur. Keeps Sr. Quality Assurance Coordinator advised of areas of concern or compliance issues which may lead to untimely or inaccurate completion of responsibilities.
• Performs other tasks as assigned to support the goals of the organization

OTHER RESONSIBILITIES:

• Presents to internal or external customers as requested.
• Provides other staff with education as requested.

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 frequently required to stand; to handle or feel; to talk and to hear. The employee is occasionally required to walk, sit, reach with hands and arms and stoop, kneel, crouch or crawl. The employee must occasionally lift and or move up to 15 pounds. Specific vision abilities required by this job include close vision, depth perception and ability to adjust focus.

WORK ENVIRONMENT:

Remote position.

Benefits:

• Medical/Rx
• Dental
• Vision
• Healthcare FSA
• Dependent Care FSA
• Basic Life and AD&D
• Voluntary Life and AD&D
• Voluntary Disability
• Additional Voluntary Benefits
• Voluntary Universal Life with Chronic Condition Rider
• Employee Assistance Program (EAP)
• same day advances are available, discussed at interview.

SKILLS|EXPERIENCE:

• Bachelor’s degree required; four years or more related experience may substitute for bachelor’s degree.
• Strong oral, written and interpersonal communication skills.
• Demonstrates initiative, ability to work independently.
• Excellent organizational and attention to detail skills required.
• Able to prioritize, trouble-shoot, and problem solve.
• Must be a team player and self-starter able to exercise sound judgment to handle a variety of issues.
• Must have a high tolerance for ambiguity and the flexibility to respond quickly and appropriately to changing circumstances and priorities as necessary.
• Strong analytical and time management skills required.
• Must have ability to manage multiple and competing priorities.
• Demonstrates a sound understanding of customer service principles and practices.
• Computer skills required. Advanced use of Excel. ServiceNow experience preferred.

Job Type: Full-time

Salary: $19.50 - $25.50 per hour

Benefits:

• Dental insurance
• Health insurance
• Life insurance
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Ability to commute/relocate:

• Sparks Glencoe, MD 21152: Reliably commute or planning to relocate before starting work (Required)

Education:

• Bachelor's (Required)

Experience:

• Healthcare management: 2 years (Required)
• Electronic Funds Transfer (EFT): 2 years (Required)

Shift availability:

• Day Shift (Required)

Work Location: Remote

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