Financial Quality Assurance Auditor
Financial Quality Assurance Auditor Requisition #: 170547 Location: Johns Hopkins Hospital/Johns Hopkins Health System, Baltimore, MD Category: Clerical and Administrative Support Work Shift: Day Shift Work Week: Full Time (40 hours) Weekend Work Required: No Date Posted: May 18, 2018 Johns Hopkins Health System employs more than 20,000 people annually. When joining the Johns Hopkins Health System, you became part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. Great careers continually advance here. Position Summary: Reporting to the Financial Clearance Manager, the Financial Quality Assurance Auditor will be responsible for monitoring, evaluating, and reporting on the performance of the financial clearance process. The incumbent will complete and review audits on accounts, identify errors and trends; document scores and maintain audit records; and provide standard and ad hoc reports including, but not limited to, performance, volume, and trend statistics. The scope of work may include, but is not limited to, benefit verification, obtaining authorizations and/or referrals, documentation, customer service quality, and complex processes, such as extended recovery. The Financial Quality Assurance Auditor will complete and review audits with staff members; provide feedback and recommendations to Manager/Supervisors and Trainers on staff performance; identify errors and trends; document scores and maintain audit records; and provide standard and ad hoc reports including, but not limited to, performance, volume, and trend statistics. Further, this position will assist in the evaluation and analysis of departmental performance for the purposes of providing feedback and recommendations for performance improvement initiatives, as necessary. Competencies: Education: Requires a minimum of an Associate's degree. Experience beyond the work experience requirement may be substituted for the degree on a 2 years of experience for 1 year of education basis. ie 4 years. Knowledge: Advanced knowledge and demonstrated proficiency in medical insurance plans, billing and regulations, and manage care plans Working knowledge of CPT and ICD-10 codes as they relate to financial clearance Familiar with multiple payer insurance verification and pre-certification guidelines Skills: Requires advanced analytical skills to resolve problems and provide patient and referring physicians with information and assistance with pre-registration and registration issues Requires analytical skills to perform calculations for financial work up and deductibles and to receive payment Requires analytical skills to assess quality assurance workflows, policies, and program evaluation Ability to develop reports and monitoring tools, and maintain department statistics for program analysis Required Licensure Certification, etc. Certification on appropriate registration system is required during the 90-day introductory period Successful completion of departmental training program and all related competency assessments Coding Certification is a plus Work Experience: 2-3 years relevant work experience in healthcare, medical office, hospital, or similar customer service Full Time (40 hours), Day Shift (8:30a - 5:00p ) Non-Exempt, Pay Grade: NF Work Location: JH @ 3910 Keswick Rd Work Condition: Works in normal office environment where there is little discomfort to due to the extremes of heat, dust, noise, temperature and the like Johns Hopkins Hospital is a Smoke-Free Campus. Johns Hopkins Health System and its affiliates are drug-free workplace employers. Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.Company Description:Patients are the focus of everything we do at The Johns Hopkins Hospital. From our beginnings in 1889 to the opening of our most advanced patient facilities in 2012, our mission to advance patient care, education, and research, continues to change the course of modern medicine.