Medical Billing, Quality Assurance

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🕒 Julho 28

🇺🇸 Estados Unidos – Remoto (EUA)

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

🔧 Engenheiro de QA (Qualidade de Software)

🗣️🇺🇸🇬🇧 Inglês obrigatório

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Logo of Sarnova

Sarnova

1001 - 5000 funcionários

Fundada em 2008

🏥 Saúde

🤝 B2B

☁️ SaaS

💰 $500.000 Venture Round - Sarnova em 2009-12

Healthcare • B2B • SaaS

A Sarnova é uma empresa de distribuição e serviços focada em saúde, cujo grupo de negócios (incluindo Bound Tree Medical, Tri-anim Health Services, Cardio Partners e Digitech) fornece produtos, equipamentos, serviços e tecnologia para todo o continuum de serviços médicos de emergência (EMS) e cuidados agudos. Há quase 50 anos, o grupo distribui mais de 100 mil produtos de saúde e segurança para prestadores de EMS, hospitais, escolas, empresas e agências governamentais, além de fornecer soluções para cuidados respiratórios/anestesia/atenção crítica, vendas e gestão de programas de DEA, treinamento de RCP e uma plataforma de faturamento e inteligência de negócios em nuvem para EMS. A Sarnova é uma empresa do portfólio de Patricia Industries/Investor AB.

Descrição

• Perform detailed quality reviews of all Medicare/Medicaid claims after coding and before submission to ensure accuracy, compliance, and completeness • Examine patient care reports (PCRs) to confirm documentation supports the billed level of service and adheres to payer rules and medical necessity standards • Validate coding selections, including level of service assignments, mileage accuracy, and required clinical indicators • Ensure documentation compliance with federal, state, and payer regulations, including signature requirements, narratives, interventions, and supporting details • Verify claim readiness by ensuring all required documentation and attachments are present prior to releasing the claim • Identify discrepancies or errors and take action to correct, escalate, or return claims to coders for further review • Maintain high-volume throughput while consistently meeting accuracy and productivity expectations. • Collaborate with Coding, Billing, QA leadership, and other internal teams to resolve questions or clarify documentation issues • Support continuous quality improvement by identifying trends, gaps, or training opportunities. • Additional job duties as assigned

🎯 Requisitos

• High School Diploma or equivalent • Clinical or medical background strongly preferred: LPN, RN, EMT, Paramedic, LNA, Medical Aide, or equivalent experience • Strong understanding of medical terminology, EMS clinical documentation, and healthcare billing standards • Ability to navigate and work efficiently across multiple computer programs simultaneously • Must have reliable home internet with speeds of 15 Mbps or higher • Must successfully complete a basic computer skills assessment prior to interview; typing test for speed and accuracy may also be required • Excellent attention to detail, accuracy, and documentation review skills • Strong time-management skills with the ability to meet tight deadlines and maintain high productivity • Ability to remain focused, organized, and productive in a remote, independent work environment • Strong communication skills, both written and verbal, with professionalism and excellent judgment. • Dependable, punctual, and comfortable asking questions or seeking clarification when needed • Ability to remain calm and effective in a fast-paced, time-sensitive workload environment • Ability to independently manage all aspects of the job role including required goals and business practices in a remote environment

🏖️ Benefícios

• Competitive salary, commensurate with experience • Comprehensive benefits package • 401(k) Plan • Equal Opportunity Employer

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