Medical QA Claims Specialist

LHH is seeking a QA Claim Specialist to help with claim audits for a healthcare facility located in Phoenix, AZ.

Ideal candidate

• A minimum of 3 years of recent experience in quality assurance
• Advanced Excel experience (VLOOKUPs, pivot table, and database management understanding)
• Articulate, excellent written and verbal communications skills, analytical, ability to work independently and in a team environment
• Experience with GE Centricity is a plus!

Responsibilities

• Reviews/develops system reports to assist in monitoring department productivity, account receivable trends, and payer issues.
• Performs monthly auditing employee audits to ensure compliance and identify training opportunities.
• Performs monthly system audits to ensure compliance and fee schedules are verified.
• Collaborates with leadership to prioritize projects based on risk evaluated through the audit.
• Determines trends in employee production activity to establish benchmarks.
• Assists in the implementation of production changes to support efficiencies and business initiatives.
• Performs and reviews data exception reports to ensure data is corrected and continuously validated.
• Ensures system libraries, constants, and general configurations meet production and security requirements.
• Demonstrates a broad cross-functional knowledge of the department and of the company to evaluate best practices.
• Research causal factors and offers potential solutions to adverse trends.
• Presents findings and recommendations to leadership.
• Available for focused sample auditing for critical issue identification.
• Any other duties as assigned.
• Supports company Safety Management System activities.
• Complies with company HS&E policies and procedures.
• Understands and provides visible support for Destination Zero

$20-24 DOE

Phoenix, AZ (Onsite)

Full Time 6 am-4 pm, M-F