Address
Form of workPosition: Document Quality Assurance Representative
Company: Medshore Ambulance
Location: Anderson, SC
Definition:
The DQA Representative is responsible for ensuring that information and documentation required for proper billing of claims is obtained and present for all billable events for an assigned area.
Minimum Requirements:
- High School Diploma
- Associates Degree, Coding Certification, or related experience (preferred)
- Must have the ability to properly perform job responsibilities as listed
- EMS Charts experience is preferred
Physical Requirements:
- The ability to reach, push and pull.
- The ability to sit or stand for long periods of time.
- The ability to use a computer keyboard and write for extended periods of time.
- The ability to lift and maneuver 35 pounds without difficulty.
- The ability to complete all job duties.
Reports To:
- DQA Manager
Specific Duties:
- Demonstrates knowledge, understanding and compliance of company policies and procedures.
- Demonstrates knowledge and understanding of (and compliance with) Federal, State and local laws, rules, regulations, and guidelines as they pertain to reimbursement, collections, and compliance.
- Demonstrates complete knowledge of proper billing, coding and posting procedures.
- Ensure security of buildings and all other company property.
- Performs daily appropriate housekeeping duties.
- Ability to work as a team member.
- Complete and maintain appropriate training, certification and licensure for their position.
- Maintain a high level of customer service when dealing with patients, patient families, co-workers, clients, other healthcare providers and the general public.
- Notify DQA Manager of any lapses in documentation resulting in less than full compliance with compliance and HIPAA standards.
- Maintains security and privacy of all company and patient information at all times in accordance HIPPA and all other local, state and federal regulations.
- Is responsible for keeping billing and patient care records secure in accordance with proper HIPAA and document retention standards..
- Reports to assigned shifts on time and properly groomed in appropriate business attire.
- At all times sets an example of professionalism and places customer service, compliance and safety above all else.
- Notifies DQA Manager of any questions, concerns or issues regarding billing, collections or compliance matters.
- Work closely with Operations and Dispatch Management and Personnel to ensure timely, accurate and complete information and documentation is available to be submitted for proper billing services.
- Thoroughly evaluate all documentation received from Operations Personnel (example PCRs, PCSs), Dispatch Personnel (example: CAD records, call types, priorities), and external customers (example: insurance and demographic information) and ensure any shortcomings or discrepancies are addressed prior to submitting documentation and information to the billing office. Should ensure that all items listed on the DQA Key Data Point Review Sheet are reviewed, present and accurate prior to submission.
- Timely process assigned work and appropriately forward information and documentation to the billing office using the assigned workflow options.
- Perform other duties related to DQA or as assigned by management.
