Audit & QI Coordinator
WFA Digital Insight
The demand for skilled professionals in healthcare reimbursement and quality improvement has grown significantly, with a 25% increase in job postings over the past year. The Audit & QI Coordinator role at Enhabit Home Health & Hospice stands out for its focus on ensuring timely and accurate billing submissions, which is crucial for the financial sustainability of healthcare organizations. As remote work continues to shape the job market, this role offers a unique opportunity for professionals with strong analytical and communication skills to make a meaningful impact in the healthcare industry. Candidates should be prepared to demonstrate their expertise in Medicare billing and quality assurance, as well as their ability to work effectively in a remote setting.
Job Description
About the Role
The Audit & QI Coordinator role at Enhabit Home Health & Hospice is a critical position that ensures the accurate and timely submission of billing claims. As a key member of the team, you will work closely with back office staff to identify and resolve billing issues, and implement quality improvement initiatives to drive business results. The role requires strong analytical and communication skills, as well as the ability to work effectively in a fast-paced remote environment.The Audit & QI Coordinator will play a vital role in ensuring that billing submissions are completed accurately and efficiently, which is essential for maintaining a low unbilled percentage and driving revenue growth. You will also collaborate with cross-functional teams to implement process improvements and ensure compliance with regulatory requirements.
What You Will Do
- Perform end of episode claim audits for Medicare patients, per current protocol
- Conduct quality face-to-face (F2F) reviews for new admissions
- Perform quality assurance (QA) audits as directed
- Follow up on open billing issues, as identified, within two working days
- Update incorrect OASIS for key field corrections discovered during billing audit
- Complete daily follow up for previous billing periods of incoming and received items that clear the claim to be billed and notify the home office billing department
- Utilize only the necessary data analytics reports in Tableau to complete audit tasks timely and efficiently
- Enter clear and precise held claim notes so the branch can complete corrections within seven days
- Assist branch employees with follow up on all outstanding claims greater than 90 days
- Manage billing responsibilities in order to keep unbilled at 10% or less of total branch revenue
What We Are Looking For
- High school diploma or equivalent required
- Two years of experience with Medicare billing or Medicare related billing functions strongly preferred
- Excellent communication and interpersonal skills
- Strong organizational and time management skills
- Ability to work effectively with minimal supervision and demonstrate a strong work ethic
- Proficiency in data analytics and reporting tools, such as Tableau
- Experience with quality assurance and process improvement initiatives
Nice to Have
- Experience with electronic health records (EHRs) and billing software
- Certification in a related field, such as medical billing or healthcare management
- Previous experience working in a remote or home-based setting
Benefits and Perks
- Competitive hourly rate
- Opportunity to work with a leading healthcare organization
- Collaborative and dynamic work environment
- Professional development and growth opportunities
- Flexible remote work arrangement
- Access to cutting-edge technology and tools
- Comprehensive benefits package, including health, dental, and vision insurance
How to Stand Out
- When applying for this role, be sure to highlight your experience with Medicare billing and quality assurance, as well as your ability to work effectively in a remote setting.
- Emphasize your strong analytical and communication skills, and provide specific examples of how you have applied these skills in previous roles.
- Familiarize yourself with Enhabit Home Health & Hospice's mission and values, and be prepared to discuss how your skills and experience align with these.
- Use specific examples to demonstrate your ability to work independently and manage multiple tasks and deadlines.
- Be prepared to discuss your experience with data analytics and reporting tools, such as Tableau, and how you have used these tools to drive business results.
- Research the company culture and be prepared to ask informed questions during the interview process.
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