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Quality Assurance Trainer - Bluecard

at HMSA

Posted: 10/2/2019
Job Reference #: 5000401049106

Job Description

Employment Type

Full-time

Exempt or Non-Exempt

Non-exempt

Job Summary

Performs audits to ensure accuracy and consistency in the operational areas. Works with management to review and analyze audit findings and follow-up on corrective actions, training and documentation as required. Participate in discussions with management team and subject matter experts to develop recommendations on enhancing system processing and desktop procedures.

Minimum Qualifications

  • A.A. degree and 1 year of related work experience; or an equivalent combination of education and related work experience
  • Good verbal and written communications skills.
  • Good working knowledge of medical terminology, health industry coding systems (procedure and diagnosis codes, etc.), CMS1500 or UB04 claim forms.
  • Good working knowledge of Microsoft Office applications
  • Overtime may be required to meet business needs. Hours may include weekends and holidays as requested and approved by management.

Duties and Responsibilities

1. Conducts audits in the operational areas to include:
  • Monthly audits to monitor controls and performance.
  • Document and review findings with operational staff and management.
  • Track audit results and spot error trends to identify training needs and process improvements.
2. Perform other functions to include: 
  • Identify specific case/scenarios beneficial for information sharing and lead discussions of case/scenario in unit meetings.
  • Conducts audit for new hires and operational staff learning new functions, transitioning to new system changes or processing procedures.
  • Develop reference and training documentation.
3. Review documents and attend meetings relating to business requirements or system changes.
 
4. Other Duties/Functions
  • Innovation, process improvement activities
  • Complete or participate in corporate training, compliance certification or initiatives as directed by management.