Quality Control Assurance Technician

Overview

Quality Control Assurance Technician Jobs in Malvern, PA at Allan Myers, Inc

Sign on Bonus: $5,000

POSITION SUMMARY:

Behavioral Health Quality Assurance Specialist will play a pivotal role in ensuring consistency and efficiency in all behavioral health contractual obligations. The candidate will have knowledge of best practices in collaboration with behavioral healthcare providers i.e. Medicaid, Medicare, Private Insurance and grant funded projects. The qualified candidate will be a leader in the industry for behavioral health quality assurance.

ESSENTIAL JOB FUNCTIONS:

· Proficient knowledge of billing policies and procedures for accuracy and timeliness

· Proficient skills in billing and behavioral health coding for Medicaid, Medicare and Private Insurances

· Thorough knowledge of the process of summiting, reviewing and correcting claims

· Understanding insurance contracting and maintaining timely filing of claims, responding to issues for Medicare and Medicaid patient related charges.

· Work with Chief Clinical Officer/leadership team to ensure all licensure requirements are being met through the Behavioral Health Administration (BHA) and agency contractual obligations

· Review and inspect Explanation of Benefits (EOB) for lost charges

· Build collaborative relationships with Behavioral Health Administrative Service Organizations (BHASO’s) including the Behavioral Health Administration (BHA), Medicaid, Medicare, Private Insurance, local state and federal partners, including foundations

· Follow through the appeals process for rejected claims and have knowledge of claim modifiers

· Understanding the Uniform Service Coding Manual-including the use of the procedure code modifiers for behavioral health

· Collaborate with Client Engagement Manager to ensure quality assurance with MHBHC Electronic Health Record (EHR) and front desk admissions

· Verify services are being provided based on quality standards

· Verify insurance information is current and active, copays are collected and fee agreements are being enforced

· Audit of MHBHC behavioral health voucher payment processes based on contractual obligation deadlines

· Collaboration with finance department in all areas of behavioral health billing and payment requests

· Support with training behavioral health staff on billing procedures, quality assurance and licensing requirements

· Other duties assigned as needed

QUALIFICATIONS:

· Experience in behavioral healthcare

· Experience with Electronic Health Records (EHR)

· Strong analytical skills to assess problems and develop action plans

· Outstanding organizational skills, and the ability to manage multiple priorities

· Attention to detail

· Strong knowledge of behavioral health licensing, billing and contractual obligations

· Strong knowledge of foundations, donor giving, state, federal and local grant making procedures

EDUCATION AND EXPERIENCE:

· Experience in Quality Assurance, behavioral health and licensure

· A bachelor’s degree required, Master’s degree preferred in related field

OTHER REQUIREMENTS:

· This position will be located in Denver in person

Requires long durations at a computer
Knowledge of a variety of computer software applications. Proficient in Microsoft Word, Office 365, Excel and Outlook

· Ability to undergo background check due to nature of work with children, adolescents and families

COMPENSATION:

This is a full-time, salaried position with benefits. Salary is commensurate with experience.

MHBHC is an Equal Opportunity Employer.

Job Type: Full-time

Pay: $65,000.00 – $70,000.00 per year

Benefits:

Dental insurance
Employee assistance program
Health insurance
Life insurance
Paid time off
Professional development assistance
Retirement plan
Vision insurance

Schedule:

8 hour shift
Day shift

Education:

Master’s (Preferred)

Work Location: In person

Title: Quality Control Assurance Technician

Company: Allan Myers, Inc

Location: Malvern, PA