Claims Quality Auditor jobs in Hilton Head Island, SC

Quality Control Auditor

Reports to:

Quality Control Manager

Headquarters:

Savannah, GA

Job Location:

Remote

What we do at Dental Claim Support:

DCS is a dental revenue cycle management company that works with dentists, dental offices and DSOs in the United States. DCS empowers dental teams by integrating highly trained RCM experts and a unique technology framework to maximize profitability and catalyze growth. Our dental billing systems and processes allow our employees to work all aspects of the full revenue cycle system efficiently, to increase profits for dental practices and groups.

Position Summary:

As a Quality Control Auditor at Dental Claim support, you will play a crucial role in ensuring the accuracy and compliance of our dental revenue cycle management services, with a specific focus on Insurance Billing. You will be responsible for evaluating and auditing various aspects of the revenue cycle management process to identify errors, discrepancies, and opportunities for improvement. The ideal candidate will have a deep understanding of revenue cycle management in the dental industry and possess strong analytical skills to maintain the highest quality standards.

How the Quality Control Auditor fits in:

The Quality Control Auditor is a critical role at Dental Claim Support, directly influencing the company's success and reputation. By meticulously reviewing insurance billing processes and documentation, this position ensures the highest standards of accuracy and compliance in our services, particularly in Insurance Billing. This contributes to enhanced revenue capture, improved client satisfaction, and process optimization, resulting in financial growth and industry leadership. Moreover, the Quality Control Auditor fosters professional development and growth within the workforce, reinforcing our commitment to excellence and integrity in dental revenue cycle management.

In this role, you will:

Revenue Cycle Management Expertise:

• Mastery of the technical aspects of dental revenue cycle management, with a specific emphasis on Insurance Billing.
• In-depth knowledge of insurance claim submission, insurance payment posting, Coordination of benefits, working outstanding claims and applying effective reimbursement procedures.
• Proficiency in CDT, ICD-10, and ADA coding standards.

Attention to Detail:

• Exceptional attention to detail and accuracy in auditing and reviewing ledgers, transactions and payments.
• Ability to spot errors, inconsistencies, and discrepancies in claim submission and outstanding claims aging reports.

Compliance and Regulation:

• Thorough understanding of healthcare compliance regulations, including HIPAA, to ensure all billing practices adhere to legal and ethical standards.
• Keep abreast of industry changes and updates related to dental revenue cycle management.

Analytical Skills:

• Strong analytical and problem-solving abilities to identify root causes of errors and suggest improvements.

Communication Skills:

• Excellent written and verbal communication skills to provide feedback, document findings, and collaborate with key stakeholders.

Quality Assurance:

• Ability to implement quality control processes and procedures to maintain the highest standards of service.
• Conduct internal audits and quality checks to ensure compliance with company policies and industry best practices.

Project Contributor:

• Proven ability to effectively contribute to specialist revenue cycle management projects, including but not limited to RCM process improvements, insurance aging report clean up, and workflow optimizations.
• Experience in leading or participating in insurance aging report clean-up initiatives to reduce outstanding insurance account receivables and improve insurance collections.

Continuous Learning:

• Commitment to ongoing learning and professional development in the field of revenue cycle management.
• Proactive in staying updated on industry trends, continuing education and practice management softwares.

Cross-Functional Collaboration:

• Ability to collaborate effectively with cross-functional teams, including Account Specialists, Account Managers, Human Resources (Hiring and Training), and external vendors to resolve issues and improve processes.
• Foster a culture of teamwork and knowledge sharing within the organization.

Success Criteria:

• Consistently maintaining a high level of accuracy and compliance in all insurance billing activities.
• Identifying and addressing revenue cycle management errors and discrepancies, resulting in improved revenue capture and client satisfaction.
• Implementing effective quality control processes that result in error reduction and process improvements.
• Providing clear and actionable feedback to team members, leading to enhanced performance and professional growth.
• Staying up-to-date with industry regulations and sharing knowledge with the team to ensure ongoing compliance.
• Demonstrating a commitment to continuous learning and contributing to cross-functional collaboration efforts that lead to improved processes and outcomes.

Requirements:

• 3 years dental insurance billing. Knowledge of dental terminology and effective dental revenue cycle management techniques.
• High School diploma or GED; some college coursework preferred.
• Proficiency in Microsoft Office (Excel, Word, Outlook, etc.) and Google Drive.
• Proficiency in using practice management software (e.g., Dentrix, Eaglesoft, Open Dental, etc).
• Excellent organizational skills and the ability to manage multiple tasks and deadlines efficiently.
• Willingness to adapt to changing regulations and industry standards.
• Strong interpersonal skills and the ability to work collaboratively in a team environment.

Compensation:

$40,000 salary commensurate with experience

Benefits:

• Health insurance provided
• Vision, and Dental Coverage
• Company matched 401k
• The option to work remotely
• A flexible work schedule
• Paid Time Off
• A culture of learning
• The opportunity to play a key role in a rapidly growing company

Our Company Values:

• Customer Success
• Transparency
• Reliability
• Professional Excellence
• Alignment