Quality Assurance Specialist Virtual

Expert (10 + years )
HCA Healthcare
Hospital & Health Care
Remote UTC1645
Job Category
Actuary Specialist
Skills Required
Equal Opportunity, Tuition Reimbursement, Growth Opportunities, Total Compensation, Competitive Salary

SHIFT: Work From Home

SCHEDULE: Full-time

Do you have exceptional customer service and the ability to plan organize and exercise sound judgment? Do you demonstrate communication, problem solving and case management skills and the ability to act/decide accordingly? Now is the time to join our team of motivated and nurturing individuals working to assist patients with their Medicaid Eligibility screening and enrollment. Ideal candidates will have a steady work knowledge of medical terminology, practices and procedures, as well as laws, regulations, and guidelines. You should also share a passion for our purpose, "To serve and enable those who care for and improve human life in their community."


Does this sound like you? If so, APPLY TODAY. See what makes us a fabulous place to work!

What We Can Offer You
  • We offer you an excellent total compensation package, including competitive salary, excellent benefit package and growth opportunities. We believe deeply in our team and your ability to do excellent work with us.
  • Your benefits package allows you to select the options that best meet the needs of you and your family. Benefits include 401k, paid time off medical, dental, flex spending, life, disability, tuition reimbursement, employee discount program, employee stock purchase program and student loan repayment.
What You Will Do
  • Perform quality assurance activities for Medicaid eligibility operations to ensure that work efforts satisfactorily meet customer requirements in a systematic, reliable fashion, effectively using systems to do so.
  • Perform analytical assessments of data and assist the management team in using the data for decision-making purposes.
  • Maintain prompt and accurate documentation outlining all steps of the QA program that have been taken in individual organized files. Complete the proper forms. Audit the assigned number of accounts per day following a set schedule. Forms will be completed and submitted within required timelines.
  • Work independently with various departments to ensure revenue is maximized.
  • Maintain reports that are indicative of process improvement within departments while promoting a positive presence in improving these processes.
  • Make recommendations based on assessments that improve production and quality.
  • Ability to multi-task to ensure day-to-day work is complete as well as assigned projects.
  • Coordinate QA findings with appropriate departments, internal or external, and ensure that necessary follow up is done to resolve any negative results.
  • Provide documented results and process improvement to Director for departments not meeting company/client standards.
  • Perform special projects or other activities as assigned. Establish and maintain constructive working relationships with coworkers, supervisors, managers and executives, as well as external clients and other external business contacts.
  • Document progress notes to the patient's file and the hospital computer system.
  • Participate in ongoing, comprehensive training programs as required.
  • Required to make field visits as necessary.
  • Proficient knowledge of Government Assistance Programs, including Medicaid/Medi-Cal and SSI/SSD and the application process for each to ensure successful conversion of accounts.
  • Familiarity with Medicaid billing and reimbursement processes including retro-certification process desired. Capable of meeting production quotas.
  • Ability to resolve problems and make recommendations for process improvement.
  • Demonstrated analytical, communication and problem solving skills and the ability to act/decide accordingly.
  • Ability to collect, create and research complex or diverse information.
  • Must pay attention to detail and accuracy.
  • The ability to plan, organize and exercise sound judgment.
  • Ability to work effectively both independently and as part of a team.
  • Demonstrated leadership, analytical, communication and problem solving skills and the ability to act/decide accordingly.
  • Ability to collect, synthesize and research complex or diverse information.
  • Travel requirements <25%
  • Exceptional customer service and the ability to plan, organize and exercise sound judgment.
  • Strong customer service skills required
  • Analytical ability a plus.
  • Must be organized.
  • A minimum of 3 years’ experience within Medicaid Eligibility, preferably as both a hospital-based screener and an application processor.
  • Experience with standard suite of Microsoft office software products.
  • Intermediate to advanced proficiency with Excel and Word required.
About Us

Parallon is an industry leader in revenue cycle services. We partner with over 650 hospitals and 2,400 physician practices nation-wide. Our parent company, HCA Healthcare has been consistently named a World’s Most Ethical Company by Ethisphere and is ranked in the Fortune 100. We are dedicated to ensuring our patients have the best experience even after they leave our facilities.

We are an equal opportunity employer and we value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status or disability


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