This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).
Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a Medicaid Quality Assurance Specialist today with Work from Home.
Job Summary and Qualifications
The QA Specialist is responsible for providing quality assurance and support for the ME Director of Operations Analysis and Reporting. Provide auditing and analytical support to ensure quality and assist in improving various processes within the Medicaid Eligibility service line.
- Review Eligibility Approvals
- Move within Patient Management and Hospital Systems after updating Approvals
- Assign Eligibility Approvals where a potential Authorization is needed to corresponding assigned employee
- Review and retrieve all Initial Referrals for corresponding hospitals from external client patient management systems
- Request MRs as need from external client
- Send Adjudication Notices to clients and update Adjudications in client system as needed
- Review Billing Follow-up to retrieve payments for Invoice and post payments as needed
- Acts as back-up in times of account overflow for clinical submissions
- Assist with escalation of accounts with the different state agencies
- Assists with the research needed to implement new clients based on state specific requirements
- Reviews patient management system reports to ensure progression of cases is occurring according to company standards
- Prepares AR reconciliations on regular basis. Provides ongoing client feedback to address identified process gaps.
- Provides directives to all levels of staff as needed to address errors on accounts and account follow-up
- 2 years lead and/or supervisory experience is preferred.
- Knowledgeable of Medicaid and Utilization Management Authorizations is a must.
- Proficient with computer and basic software including Excel, Word and Outlook.
- Basic knowledge of office equipment use and maintenance including network printer, copier, postage machine, fax machine.
- Work from home roles require employees must have high speed internet 60 MB download and 10 MB upload.
Benefits
Parallon, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
- Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
- Wellbeing support, including free counseling and referral services
- Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
- Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
- Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
- Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location.
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Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.
HCA Healthcare has been recognized as one of the World’s Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated 3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.
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"The great hospitals will always put the patient and the patients family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual."- Dr. Thomas Frist, Sr.
HCA Healthcare Co-Founder
If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Medicaid Quality Assurance Specialist opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
