QUALITY CONTROL COORDINATOR

Position Description: The Quality Control Coordinator performs quality review audits for offshore vendors as well as applicable onshore staff. The QCC will ensure all staff are meeting expectations and following all QA guidelines as outlined in the service level agreements, contract and PPT quality standards.

Principal Duties and Responsibilities:

• Complete quality audits for Eligibility and Benefits, Authorization Management, Patient Accounts and Correspondence RCO functions.
• Coordinates and conducts RCO staff and vendor training; ensures training documentation is current, complete and accurate.
• Functions as liaison to third party for special projects as it pertains to reconciling payments, i.e. APOS, HSS, and PACE.
• Responsible for assisting with user acceptance testing (UAT) in our EMR Software for all RCO departmental new functionality and changes of existing functionality.
• Assists with BOT development vendor as needed.
• Behaves in a manner consistent with Professional’s mission, vision and values.
• Maintains a working knowledge of HIPAA, OSHA, Risk Management and compliance regulations.
• Attends Company meetings as required.
• Attends training classes as directed and completes assigned training courses.
• Practices confidentiality in accordance with Company policies and all laws and regulations.
• Other duties as assigned by the Vice President, Revenue Cycle Operations.
• Stays abreast of laws and regulations affecting reimbursement.

Qualifications:

• Bachelor’s degree highly preferred.
• At least 3 years of health care management, with emphasis on front-end insurance verification, authorization management, and AR follow-up.
• High School diploma or at least 3 years of experience with adult classroom training and/or virtual training
• Thorough knowledge of/proficiency with Microsoft Office is required.
• Demonstrated skills in revenue cycle management and problem solving skills.
• Strong organizational and time management skills are required.
• Embraces diversity within the work environment and consistently deals with internal and external customers in a friendly and respectful manner; supports teamwork and cooperation with work partners in daily activities.
• Excellent analytical and problem-solving skills.
• Excellent communications skills are required.
• Ability to work independently and follow-through and handle multiple tasks and/or special projects simultaneously.

Professional provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.