Home Medical Equipment Quality Assurance Specialist, with the assistance of other QA Specialist(s), performs concurrent 100% record reviews for compliance of federal and state rules and regulations and agency policies; monitors factors which directly and indirectly influence the billing and payment for the care rendered to the Agency's patients.Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This position requires the ability to maintain confidentiality of all incoming personal and private information, no exceptions. Primary Responsibilities:Performs 100% record reviews for compliance of federal and state rules and regulations and agency policies; monitors factors which directly and indirectly influence the billing and payment for the care rendered to the Agency's patientsReviews that all needed information is in the Sales Order (i.e., demographics, clinicals, correct insurance, correct procedure codes, eligible diagnosis, etc.)Reviews Delivery Tickets against the information in the computer (Brightree) to make sure items are billed correctly, and that the required documentation has been procured and scanned into Brightree for all branchesAssists with entering orders into Brightree from physician's orders for DME Closets from all branches and performs the 100% record review on these ordersAssists in reviewing and confirming Pickup / Exchange tickets from all branches except for San AntonioDemonstrates effective written and verbal communicationComplies with all agency policies and procedures. Promotes and maintains agency environment that is in compliance with federal, state, and local regulatory guidelinesParticipates in personal professional growth and developmentDemonstrates flexibility, enthusiasm and willingness to cooperate while working with others or in place of others as necessaryPerforms other duties as assigned
Required Qualifications:High school education / GED2 years of experience in Home Medical Equipment (HME)Basic knowledge of Excel, Outlook, and WordEmployee must be able to work standard department hours of 7:30am until 4:30pm Preferred Qualifications:Experience with Brightree Electronic Records programGood organization, communication, human relations skillsSelf-motivation, assertiveness and independent decision-making skills are essentialMust be able to read and follow written and verbal instructions in English effectivelyPossesses ability to operate computer terminal, printer, fax and copier machinesKnowledge of general office proceduresExcellent computer skills and knowledge of word processing and Excel highly desirableMaintain privacy and confidentiality with regard to all patient, staff & agency informationProblem solving skillsInterpersonal skillsCommunication Proficiency (Oral & Written)Project & Time Management skillsEthical Conduct – follows appropriate chain of commandAdaptability & DependabilitySafety & SecurityThoroughness Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 90,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm) Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. Job Keywords: Home Medical Equipment, HME, Quality Assurance, QA, San Antonio, TX, Texas
Our mission is to help people live healthier lives and to help make the health system work better for everyone.- We seek to enhance the performance of the health system and improve the overall health and well-being of the people we serve and their communities. - We work with health care professionals and other key partners to expand access to quality health care so people get the care they need... at an affordable price. - We support the physician/patient relationship and empower people with the information, guidance and tools they need to make personal health choices and decisions.