The Patient Financial Services (PFS) Quality Control Analyst supports the quality assurance activities related to the billing and collections processes. The PFS Quality Control Analyst will work with both Patient Financial Services management and staff to perform front-to-end quality audits to ensure accurate billing and adherence to both Standard Operating Procedures and trained protocols. The PFS Quality Control Analyst will also assist with tracking and trending Quality Assurance review data and provide input regarding policy and procedure improvement.
Position Duties and Responsibilities:
Assist in the development of Quality Assurance scorecards to be used for front-to-end audits of complete billing, coding, collections, cash posting and other related functions within the Patient Financial Services department
Conduct monthly audits to provide quality assessments to PFS management
Assist in periodic compliance audits to ensure correct billing practices
Develop reports to identify and help manage areas of improvement within the revenue cycle
Coordinates with PFS Managers and training team to ensure that all quality standards are communicated and up-to-date based on approved Standard Operating Procedures
Demonstrate subject matter expertise in one or more revenue cycle functions (Insurance Verification, Authorization,
Patient collections, Collections, etc.) as well as high attention to detail to be used in the evaluation of quality adherence
Assists in the validation of billing software and practices to ensure quality standards are met
Other projects as assigned
1+ years' experience in a medical billing or related role
Experience in Quality Assurance or Auditing a plus
High school diploma or equivalent, college degree a plus or equivalent experience
Knowledge of CPT/HCPCS codes, medical terminology, insurances, claims processing preferred
Experience with Microsoft Office programs a plus (Excel, Outlook, Word, and PowerPoint)
Must have excellent computer skills
Must understand the full revenue cycle process, with specialized understanding of one or more RCM functions
Must have excellent investigative and researching skills
Must be able to multi-task
Must be analytical, detailed-oriented and organized
Must be able to meet deadlines in a timely manner
Must be very tech-savvy and able to learn new systems and processes quickly and effectively
Location and Shift Schedule:
Ambry Genetics Corporation is a CAP-accredited and CLIA-licensed molecular genetics laboratory based in Aliso Viejo, California. We are a genetics-based healthcare company that is dedicated to open scientific exchange so we can work together to understand and treat all human disease faster.
At Ambry, everyone is welcome. A career at Ambry Genetics is a chance to be part of a dynamic company that aims to improve health by understanding the relationships between genetics and human disease. We earned our reputation as industry leaders by responsibly introducing cutting-edge genetic testing solutions and continually sharing what we learn with the global scientific community. We also support those with genetic conditions through the Mauli Ola Foundation and other nonprofit organizations. At Ambry you will be learning, challenging yourself, and having fun while collaborating with teammates through the open exchange of ideas.
Employees at Ambry Genetics have many perks, including an onsite caf with complimentary smoothies and infused waters! We also offer access to gym memberships, onsite food trucks, "Lunch and Learns," Pajama Days, Chili Cook-Offs and more. Our outstanding benefits program includes medical, dental, vision, 401k, FSA, generous paid time off (PTO) program, and flexible scheduling as determined appropriate. Ambry Genetics is an Equal Opportunity Employer (EOE) and we maintain a drug-free work environment.
Ambry Genetics is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.