Quality Assurance Auditor

Description

BHS - Billing Quality Control (QA/Payroll Specialist)

Mahajan Therapeutics is looking for a QA/Payroll Specialist. The Billing Quality Control primary job function is to coordinate all agency activities relating to proper utilization, handling and maintenance of the client treatment records. Performs other duties as assigned.

Essential Job Functions

• Ensuring the appropriate maintenance and auditing of all individual client records in EHR.
• Conducts daily and weekly documentation audits to ensure accuracy and compliance reporting any discrepancies to the Treatment Center Director and report in EHR.
• Assists in auditing discharge charts for completion and accuracy
• Conducts biweekly billing audits of all billable services, including coordinating billing to the billing company
• Review all notes to match ISP goals / clinical documentation.
• Monitors accuracy of all currently used forms and EHR procedures.
• Reports to Treatment Center Director weekly on all duties involved with ISP’s, chart errors and documentation errors and puts alerts in EHR.
• Failed activities and failed claims reconciled daily.
• Staff relationship change in EMR.
• QA all notes in EMR in accordance to medical necessity.
• Reconcile denials with Claim Specialist timely.
• Reconcile all billing, timecards and EHR reports. Payroll input and accuracy checked
• Adequate knowledge and ability to navigate EHR (Electronic Health Record) system.
• Assists with light clerical duties such as filing, copying and typing.
• Responsible for verifying insurance eligibility information.
• Follows all clinic policies and procedures, as well as, state and federal regulations.
• Assists with chart audits, filing, and making new charts.
• Responsible for input of payroll data for the Case Managers.
• Other duties as assigned.
  
  

Minimum Qualifications

• High school diploma or equivalent from an accredited secondary education institute required.
• Experience and knowledge of state and federal healthcare regulations required.
• Prior experience with identifying if a patient meets criteria for admission to a program.
• Demonstrated experience in managing multiple priorities.
• Must be a self-starter, proactive, organized and possess strong interpersonal and communication skills with the willingness to learn required.
• Must have a detail-oriented approach and be able to maintain a high level of ownership and accuracy.
• Proven competency with MS Office applications, including Word, Excel and PowerPoint required.
• Adaptability in a challenging and dynamic environment; understand and work well in a matrixed organizational structure required.
• Satisfactory references from employers and/or professional peers and satisfactory criminal background check.
• Satisfactory drug screen
  
  

Benefits:

• Competitive salary
• Comprehensive benefits package including medical, dental, vision and 401(K)
• Generous paid time off accrual
• Excellent growth and development opportunities
• Satisfying and rewarding work striving to overcome the opioid epidemic
  
  

Here is what you can expect from us:

Mahajan Therapeutics, a progressive substance abuse treatment organization, is committed to the highest quality of patient care in a comfortable outpatient clinic setting.Our ultimate goal is to address the physical, emotional, and mental aspects of opioid use disorder to help each of our patients achieve long-term recovery and an improved quality of life.

Mahajan Therapeutics is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, citizenship, genetic disposition, disability or veteran’s status or any other classification protected by State/Federal laws.