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richmond charlotte raliegh Northern VA norfolk
SPECIALTY AREAS: MEDICAL AND DENTAL PROFESSIONALS | CLINICAL AND ADMINISTRATIVE SUPPORT SERVICES
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Quality Assurance Reviewer - Worker's Comp

Location : Richmond, VA
Job Type : Temp/Contract

Job Description :
Quality Assurance Reviewer needed for review on case management invoices & reports.

 

Position is part-time, 3 days/wk - must work in office (not remote) and be a go-getter & teamplayer.

 

Must have worker's comp or medical case management experience.

 

Review of job duties:


 


Review invoices to determine if charges are reasonable, appropriate, and within the customer’s billing guidelines.


 


Examine reports for proper medical case management documentation and completeness Generate finalized QA invoice and support to be sent to the customer.




 


Analyze audit reductions timely and request refunds on disputed invoices. 


 


Respond to communication from the field offices regarding reporting issues or billing


questions.  Provide constructive feedback on areas needing improvement.


 


Evaluate and resolve pending reports and invoices.  Follow up with field office on items sitting


in a “draft” status for more than a week.  


 


Participate in monthly QA team meetings and provide update on quality issues to QA


Supervisor.


.        


Ability to stay focused on task completion in high volume environment.


 


 


 


 



 REQUIRED EDUCATION/TRAINING:


 


5 years of work experience in the healthcare or insurance field, workers compensation and medical case management background preferred


 


Ability to review, interpret and process large amounts of information efficiently with strong attention to detail


 


Ability to work independently using analytical skills and good business judgment


 


Intermediate to advanced skills in Access, Excel and Word applications


 


Proficient in use of computers (dual monitors and mouse)


 


Excellent typing and alpha/numeric data entry skills (10-key and typing by touch)


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