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Accounts Receivable Quality Assurance Specialist in Brentwood, TN at Compassus

Date Posted: 11/20/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Brentwood, TN
  • Date Posted:
    11/20/2018
  • Job ID:
    2018-07170

Job Description



Current Compassus Colleagues: Please apply via Workday.

Position Summary

As an Accounts Receivable Quality Assurance Specialist, you will be responsible for ensuring all revenue booked by the company can be supported by the documentation present during the admission process. This is done by reviewing and checking all admission paperwork necessary for complete and accurate billing.  S/he will work closely with each of the programs to correct paperwork that contains technical errors and maintain a log of all new admissions so that a program scorecard can be generated on a monthly basis.  The Accounts Receivable Quality Assurance Specialist will review results with each of their programs and assist the programs in developing mitigating processes to reduce errors in the future.  The Accounts Receivable Quality Assurance Specialist will also work closely with the other billing teams to ensure corrected elections are re-submitted timely.

Principal Accountabilities

  • Supports corporate policies, goals and objectives.   
  • Promotes a positive working relationship between corporate and agency colleagues.
  • Provides support and consultation to both Corporate and agency personnel.
  • Attends and participates in staff meetings.
  • Promotes hospice philosophy.
  • Communicates identified needs and potential solutions to supervisor.
  • Runs pre-billing reports on assigned programs and pre-billing claims for review.
  • Monitors as well as assist the programs as needed with financial classes and recertification dates.
  • Reviews admissions paperwork for completeness and accuracy.
  • Is knowledgeable of appropriate data required on claims and assures filing of accurate claims according to payer specifications.
  • Assembles required back up and approvals for AR adjustments and turns them into their Manager.
  • Assembles required back up with Executive Director and Regional Clinical Director approvals for any account balances that will result in bad debt and submits it to the AR Manager for additional approval.
  • Is able to self-organize their work assignments to assure efficiency and effectiveness.
  • Maintains up-to-date knowledge of Insurance Contracts, and notifies Team Leader or Manager in writing of any problems or deviation from contract.
  • Maintains up-to-date knowledge of Medicare, Medicaid, and Private Insurance rules/procedures/and rates for billing.
  • Verifies that every related office has received any necessary paperwork in a timely manner.
  • Performs monthly status checks on all current ADR patients.
  • Performs other duties as assigned.

Knowledge and Skills

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

High School diploma or GED required. Associate's degree or equivalent from two-year college or technical school preferred; minimum of one year experience in healthcare billing systems and/or training in data processing on micro-computer systems and third party billing in a health care setting.

Mathematical Skills

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percentage.

Language Skills

Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from leaders, colleagues, investors, and external parties. Strong written and verbal communications.

Reasoning Ability

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, or schedule form.

Computer Skills

Proficiency in Microsoft Office Suite.

Other Qualifications

Strong organizational and time management skills. Must be able to work a flexible schedule to include nights and weekends. Possesses familiarity with medical terminology and medical records.  Possesses effective communication and organizational skills. Maintains a professional demeanor and appearance and is self-motivated and dependable. High integrity, including maintenance of confidential information, such as patient records.

Certifications, Licenses and Registrations

A valid driver’s license and auto liability insurance.

Other Skills and Abilities

Ability to understand, read, write, and speak English. Articulates and embraces hospice philosophy.

Physical Demands

The physical demands described here are representative of those that must be met by a colleague to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the colleague is regularly required to use hands to finger, handle, or feel; talk and hear. The colleague frequently is required to stand, sit, and reach with hands and arms. The colleague is occasionally required to walk; climb or balance; stoop, kneel, crouch, or crawl; and taste or smell. The colleague must frequently lift and/or move more than 50 pounds. Specific vision abilities required by this job include close vision.

Work Environment

The work environment characteristics described here are representative of those a colleague encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

There will be possible exposure to infectious diseases through working with clinical caregivers.  The noise level in the work environment is usually quiet.

Compassus, including all Compassus affiliates, complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Compassus, including all Compassus affiliates, does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

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