Quality Assurance Associate
Community Surgical Supply is one of the largest independently owned homecare companies in the midatlantic and northeast region, aggressively looking to increase market share throughout the country. As a premiere homecare provider, we adhere to the highest standards of excellence both for our employees as well as for our patients.
We are an organization that is proud of the reputation it has acquired as being "a good place to work", a place where friendliness and fairness prevail. We want you to feel that you are a part of a company whose success depends on the knowledge, skills, and attitudes of the people who function in harmony as a team. We encourage independent thinking on a team level to help develop fresh ideas to achieve organizational goals.
As the Quality Assurance Associate with Community, you will:
Review of all Medicare documentation, prior to delivery, to ensure all orders are compliant with Medicare LCDs, face-to-face requirements, and valid chart notes substantiating the medical need for equipment being ordered.
Review audit requests/denials from the billing department, obtain necessary documentation for appeals.
Communicate, on a weekly basis, with the Medicare Billing Supervisor on denials and outstanding audit requests.
Communicate, on a weekly basis, with Customer Service Management regarding CSRs performance as related to the qualifications of their Medicare orders.
Assist, on a regular basis, in training staff on Medicare rules and regulations.
Stay current with Medicare changes/requirements and communicate to Customer Service.
Perform other duties as assigned by management.
Requirements and Qualifications:
Prior Medicare collection or related experience. Home Medical Equipment (HME) or Home Respiratory collection or billing experience preferred.
Knowledge of Home Care Industry and product knowledge.
Must be proficient in medical billing, collection and appeals processes associated with Medicare.
Dynamic, energized, positive personality; Good motivator and coach.
Excellent customer service/interpersonal, verbal and written communication, problem solving, critical thinking, organizational, and follow through skills.
Strong computer skills and ability to analyze and report data.
Ability to remain calm and productive in an often fast-paced environment and to deal effectively with challenging demands.
The physical demands described here are representative of those that must be met by an associate 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, this sedentary position requires an associate to regularly sit, use hands to finger, handle or feel and talk or hear. The associate is occasionally required to stand; walk and reach with hands and arms. The associate may occasionally exert up to 10 pounds of force, and/or a negligible amount of force frequently or consistently to lift, carry, push, pull or otherwise move objects, including the human body. Specific vision abilities required by this job include close vision, distance vision, depth perception and ability to adjust focus.
Community Surgical Supply conducts drug, background and motor vehicle checks in our hiring practices.
Community Surgical Supply recruits and retains talented individuals without regard to gender, race, age, marital status, disability, and veteran status or any other status protected by federal, state or local law. Community Surgical Supply is an Equal Employment Opportunity and Affirmative Action Employer. EEO/AAE
Community Surgical participates in E-VERIFY