Job description

United Billing Solutions is seeking to expand our Quality Assurance Department with the addition of a Medical Claims Auditor or Biling Quality Assurance Specialist. This role is responsible for ensuring coding, billing, and collection compliance through ongoing audits and reporting deficiences to the Admissions Quality Assurance Manager. This is a FULL Time, on site position at our office located near San Juan, Puerto Rico.

**No direct experience is required for this position, transferable skills and experience will be considered. Salary is competitive and commensurate with experience**

Job Description:

The Medical Claim Auditor or Billing Quality Assurance Specialist is responsible for completing randomly selected audits of claims using coding, billing, and collections knowledge.

• Conducts coding, billing, and collections audits to ensure accuracy and compliance in order to maximize revenue collection.
• Recommends solutions and provides guidance in coding and clinical documentation.
• Completes billing reviews, audits, and risk assessments.
• Compares clinical and financial records to ensure that the documentation meets company standards.

Key Traits that will make you successful:

• Strong Attention to Detail
• Critical Thinking and Problem Solving
• Active Listening and Memory Retention
• Proficiency in Typing or Transcription

Responsibilities:

• Conducts compliance audits of phone calls related to claims
• Conducts compliance audits of billing documentation
• Conducts compliance audits of claim documentation
• Suggests policies for improving company operations or performance
• Tracks overall accuracy and nature of errors to measure improvement
• Investigates, analyzes, and reports inaccurate coding, denials, appeals, or rejections
• Audits new claims to identify potential issues, errors, and/or trends

Reasons to Work Here:

• Paid Time Off
• Medical Insurance
• Dental and Vision Insurance
• Company Sponsored Life Insurance
• Health Savings Account
• Flexible Spending Account
• 401(k)

Requirements:

• High School Diploma or equivalent
• Able to handle sensitive subject matter
• Discretion and protection of private information
• Excellent written and verabl communication skills
• Ability to work with computer software (Excel, Word, Salesforce, CollaborateMD)
• Minimum of 1 year experience as a certified medical auditor (preferred)
• 1 year of multi-specialty coding experience (preferred)
• Detailed knowledge of medical coding systems, procedures and documentation requirements
• Knowledge of electronic billing programs and third-party insurance payers
• Working knowledge of payer portals to verify member information
• Understanding of both in-network and out-of-network claim submission
• This is an in person, on site position, NOT remote

Job Type: Full-time

Pay: $35,000.00 - $55,000.00 per year

Benefits:

• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 10 hour shift
• 12 hour shift
• 8 hour shift
• Monday to Friday
• Weekend availability

Work Location: One location

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