Quality Auditor Sr - Rhrp - 3

Are you someone who thrives in leading and assuring daily tasks run smoothly in a result driven work place? If so we would love to speak with you!

QTC is seeking candidates for our Quality Auditor Sr opportunities for our Reserve Health Readiness Program III (RHRP-3)

• Position is located ONSITE at our San Antonio, TX location

Who is QTC and what is Reserve Health Readiness Program III (RHRP-3)?

• Reserve Health Readiness Program – 3 (RHRP-3) provides health readiness support services, such as mental health assessments and post-deployment health reassessments, to the military Reserve Components nationwide and Active Duty Components in remote areas. They deliver services by group events and in-clinic individual appointments and by providing call center support.
• QTC is the nation’s largest provider of disability and occupational health examination services. We are PASSIONATE about our country’s veterans, UNITED as a team and INSPIRED to make a difference. To provide high-quality, timely, and customer-focused medical examination service solutions, we honor our core values of integrity, innovation, agility, collaboration, inclusion and commitment. We celebrate diverse thinking and welcome contributions from all.

The part would you play in this mission.

Support the Reserve Health Readiness Program III (RHRP-3) operations by completing routine medical records office work, performing documentation and review of medical service procedures, and ensuring compliance with billing policies. You will also communicate with government agencies, regional offices, and QTC personnel to obtain and/or send medical records data.

In This Rewarding Role, You Will

• Process feedback received via phone or email, notate appropriately and forward to correct department per workflow.
• Ensure all information related to findings are appropriately documented according to company policies and procedures
• Complete most routine audit functions with minimal supervision
• Identify and research audit findings, presenting concerns and solutions to appropriate leadership
• Meet individual productivity and quality goals.
• Perform moderate to complex audits to assist in trend identification
• Process faxes received
• Analyze and validate medical records documentation to ensure the services ordered equal the services performed and billed
• Review the case management system to identify outstanding reports and diagnostic results
• Interface with operational departments to ensure customer requirements are met
• Perform other duties and responsibilities as assigned
• Report on basic metric results
• Utilize data analysis and extraction tools to evaluate billing transactions and identify potential billing errors
• Communicate with medical offices and diagnostic facilities to obtain reports
• Take escalated calls
• Upload diagnostic results received to the case management system

You Must Have

• Must be able to successfully pass contractually required Federal background check (NACI)
• High School diploma, or equivalent (GED) or 2 years of experience in lieu
• Contract requires U.S. Citizenship and the ability to obtain a DoD Common Access Card (CAC)
• Experience in a high volume healthcare setting

Preferred To Have

• Knowledge of military medical examinations
• Experience with medical terminology in a medical billing environment

Typical Day

• No Travel
• Position is located ONSITE at our San Antonio, TX location - Abilene Bldg. @ 4406 W. Piedras Dr., San Antonio TX 78228
• Flexible hours Shift - M-F 8-4:30

Pay Rate: Hourly $20

The QTC Management pay range for this job level is a general guideline only and not a guarantee of compensation or salary. Additional factors considered in extending an offer include (but are not limited to) responsibilities of the job, education, experience, knowledge, skills, and abilities, as well as internal equity, alignment with market data, applicable bargaining agreement (if any), or other law.

Pay and benefits are fundamental to any career decision. That's why we craft compensation packages that reflect the importance of the work we do for our customers. Employment benefits include competitive compensation, Health and Wellness programs, Income Protection, Paid Leave and Retirement. More details are available here.

Commitment to Diversity

QTC Management Inc. is a VEVRAA Federal contractor and an Equal Opportunity Employer. The company has an ongoing commitment to affirmative action and the creation of a workplace free of discrimination, harassment and retaliation. The company recruits, hires, trains, and promotes individuals in all job titles without regard to race, color, creed, religion, ancestry, national origin, age, sex, pregnancy, sexual orientation, gender identity, genetic information, people with disabilities protected under law, and protected veteran status.

Don’t meet every single requirement? Studies have shown that women and people of color are less likely to apply to jobs unless they meet every single qualification. At QTC, we are dedicated to building a diverse, inclusive and authentic workplace, so if you’re excited about this role but your past experience doesn’t align perfectly with every qualification in the job description, we encourage you to apply anyway. You may be just the right candidate for this or other roles.

• This job description supersedes all prior job descriptions and is intended to describe the general content and essential requirements for the position listed above. It is not to be construed as an exhaustive statement of requirements, duties, and responsibilities. Management reserves the right to add or change the duties of this position as required at any time.

Experience

Required

• 1 - 3 years: Medicare billing, medical claims processing, and audit experience

Education

Required

• GED or better
• High School Diploma or better

Skills

Preferred

• Organization
• Written Communication
• Excel
• Interpersonal
• Verbal Communication
• Problem Solving

Behaviors

Preferred

• Team Player: Works well as a member of a group
• Dedicated: Devoted to a task or purpose with loyalty or integrity
• Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well

Motivations

Preferred

• Self-Starter: Inspired to perform without outside help
• Growth Opportunities: Inspired to perform well by the chance to take on more responsibility
• Goal Completion: Inspired to perform well by the completion of tasks
• Work-Life Balance: Inspired to perform well by having ample time to pursue work and interests outside of work

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)