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QA Analyst I-RCM

QA Analyst I-RCM

One CallMadison, WI, US
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Description & Requirements

Join Our Team and Make a Difference!

Are you looking for an impactful role where you finish the workday knowing you helped someone? Whether you are part of our care coordination team or playing a supporting role, the work our colleagues do every day enables us to collectively reach our mission of getting people the care they need when they need it. By staying committed to our core values of Think Big, Go Fast, Deliver Awe, and Win Together we can positively impact the lives of the injured workers we serve and get them back to the things that matter most in life.

Salary Range :

This compensation range considers a wide range of factors, including, but not limited to, skill set, experience and training, licensure and certifications, and other business and organizational needs. The disclosed range estimate is not adjusted for geographic differential associated with the location where the position may be filled. At One Call, it is not typical for an individual to be hired at or near the top of the range for their role, and compensation decisions are dependent on the facts and circumstances of each case.

What We Provide in Return for Your Commitment to Our Mission

We offer a vast array of benefits to help support the whole you, including :

  • Remote Work : We are a remote-first company and almost all positions receive the flexibility of working from home.
  • Generous Time Off : Besides 8 company holidays and 2 personal days every year, all colleagues receive a minimum of 18 days of paid time off.
  • Comprehensive Benefits Package : Including medical, dental, vision, and pet insurance; 401(k) matching program; and company-paid life insurance and short and long-term disability coverage.
  • Supportive Services : Just like our colleagues get injured workers the care they need when they need it, we want to do the same for our colleagues in their time of need. We offer a Colleague Assistance Program that provides free counseling and financial services, and our One Call Foundation, a non-profit arm of our company, provides colleagues financial assistance during times of unexpected hardships.

JOB SUMMARY :

The Quality Assurance Analyst I-RCM is responsible for auditing, controlling, and monitoring quality assurance and compliance processes for One Call. They audit multiple teams to ensure compliance with Service Level Agreements, Health Insurance Portability and Accountability Act, Statement of Work, and Standard Operating Procedures. The Quality Assurance Analyst can work independently and operate effectively in a team environment.

ESSENTIAL DUTIES & RESPONSIBILITIES :

Quality Assurance Auditing : 70%

  • Ensures compliance and quality standards are met through the auditing of operational files.
  • Monitors, evaluates, and executes audit processes to ensure compliance and quality.
  • Documents non-compliance with policies, processes, and standards and assists in their resolution.
  • Collaboration : 20%

  • Provides feedback to operations on audit quality and compliance related issues.
  • Provides feedback and subject matter expertise related to quality and compliance trends.
  • Administration : 10%

  • Complete assigned training as required.
  • Participate in auditor calibration exercises.
  • Other duties as assigned.
  • EDUCATIONAL AND EXPERIENCE REQUIREMENTS :

  • Minimum High School diploma or equivalent required.
  • Typically requires 0-2 years of QA experience.
  • Minimum 1-2 years of experience working in Operations.
  • ESSENTIAL KNOWLEDGE, SKILLS & ABILITIES :

  • Broad knowledge of Workers Compensation products, services, business practices, and processes.
  • Strong analytical, decision making, and problem-solving skills.
  • Excellent organizational skills and attention to detail.
  • Excellent verbal, written communication, and interpersonal skills.
  • Excellent time management skills with a proven ability to meet deadlines.
  • Proficiency in MS Office Applications including MS PowerPoint, Excel, Word, and other relevant software required.
  • Ability to influence without direct authority.
  • Proficiency in at least one appropriate quality management and improvement methodology (e.g., Total Quality Management (TQM), Lean Six Sigma).
  • Bi-lingual (Spanish).
  • Ability to work in an environment that aligns with the company's diversity, equity, inclusion and belonging standards.
  • Ability to work both independently and in a teamenvironment.
  • Demonstrate our core values of Think Big, Go Fast, Deliver Awe, and Win Together.
  • PHYSICAL / MENTAL DEMANDS & WORK ENVIRONMENT :

  • This position will be performed in the colleague's home. Work-from-home requirements include the colleague's ability to set up computer equipment within their home office.
  • This job is primarily sedentary and may involve repetitive motions; thecolleaguemust be able to remain in a stationary position for extended periods of time, operate a computer and other office equipment, assess information and files stored electronically, and converse / exchange accurate information with others, simultaneously.
  • The colleague must be ableto discern text displayed on a monitor, input data into specific fields using a keyboard, andadjustfocus to distances of up to three feet.
  • The colleague must have the ability to learn new tasks, follow established processes, maintain focus, complete tasks independently, complete multiple tasks simultaneously, communicate professionally with colleagues and customers, and complete tasks in situations that require speed or productivity.
  • The colleague must be able to manage moderate to significant mental stress because of, but not limited to, a dynamic and heavy workload.
  • Please be advised that job descriptions typically change over time as business needs, job requirements, and employee skill levels change. As such, One Call retains the right to change or assign other duties to this position at any time.

    Quality Assurance (QA) Analyst I-RCM

    Both written and verbal skills are professional and error free, actively listens and responds appropriately to others, and ensures problems and potential pitfalls are reported in a timely manner (Go Fast). Proves through actions that they can be counted on to be present at work, on time, dependable, and meet deadlines while completing all assigned work or reporting when work remains unfinished for the day.

    We are an equal opportunity employer and all qualified applicants will receive consideration for employment regardless to race, color, religion, sex, nationality, disability status, protected veteran status, or any other status protected by law.

    PandoLogic. Category : , Keywords : Quality Control / Quality Assurance Analyst

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