Job Title: Quality Analyst - DME Process (Charge Entry and Payment Posting)

Job Summary: The Quality Analyst will be responsible for ensuring the accuracy and efficiency of charge entry and payment posting processes within the Durable Medical Equipment (DME) sector. The role involves analyzing and auditing billing data, identifying discrepancies, and implementing corrective actions to improve overall process quality.

Key Responsibilities:

Charge Entry and Payment Posting:

• Review and verify charge entries to ensure accurate billing for DME services.
• Audit payment postings to ensure correct application to patient accounts.
• Identify and rectify discrepancies in charge entries and payment postings.

Quality Assurance:

• Conduct regular audits of billing and payment processes to ensure compliance with industry standards and company policies.
• Develop and maintain quality control procedures for charge entry and payment posting.
• Generate reports on audit findings and recommend corrective actions.

Process Improvement:

• Analyze current processes and identify areas for improvement.
• Collaborate with billing and payment teams to implement best practices and streamline workflows.
• Monitor the effectiveness of implemented changes and adjust as necessary.

Training and Development:

• Provide training and support to billing and payment staff on quality standards and procedures.
• Stay updated with industry trends and regulatory changes affecting DME billing and payments.
• Conduct periodic training sessions to enhance team skills and knowledge.

Reporting and Documentation:

• Maintain accurate records of audits, findings, and corrective actions.
• Prepare detailed reports for management on quality performance and improvement initiatives.
• Ensure documentation is up-to-date and compliant with regulatory requirements.

Qualifications:

• Bachelor's degree in Business, Healthcare Administration, or a related field.
• Minimum of [X] years of experience in medical billing, preferably within the DME sector.
• Strong understanding of charge entry and payment posting processes.
• Excellent analytical and problem-solving skills.
• Proficiency in relevant billing software and MS Office Suite.
• Strong attention to detail and accuracy.
• Effective communication and interpersonal skills.

Preferred Qualifications:

• Certification in Medical Billing or Coding.
• Previous experience in a quality assurance role.
• Familiarity with DME regulations and compliance standards.