Audit & QI Coordinator

Overview

The Audits & Quality Improvement (QI) Coordinator I is responsible for the end of episode billing and reimbursement functions. This position works closely with back office staff to ensure billing submissions are completed timely and accurately in order to keep the unbilled percentage below 10% of total revenue.

Previous experience with unbilled reports, unsigned orders, order tracking, and FTFs is preferred.  

This position is eligible for 100% remote but the employee must reside in a state where Enhabit currently operates. AK, AL, AR, AZ, CO, CT, FL, GA, ID, IL, IN, KS, KY, LA, MA, MD, MO, MS, MT, NC, NM, NV, OH, OK, OR, PA, RI, SC, TN, TX, UT, VA, WA, WY.

Responsibilities

• Perform end of episode claim audits for Medicare patient, per current protocol.
• Perform quality face-to-face (F2F) reviews for new admissions.
• Perform quality assurance (QA) audits as directed.
• Follow up on open billing issues, as identified, within two working days.
• Update incorrect OASIS for key field corrections discovered during billing audit.
• Complete daily follow up for previous billing periods of incoming and received items that clear the claim to be billed and notify the home office billing department.
• Utilize only the necessary data analytics reports in tableau to complete audit tasks timely and efficiently; front end audit and review claims demonstration tracker.
• Enter clear and precise held claim notes so the branch can complete corrections within seven days.
• Assist branch employees with follow up on all outstanding claims greater than 90 days.
• Manage billing responsibilities in order to keep unbilled at 10% or less of total branch revenue.

Qualifications

• Must have a high school diploma or equivalent.
• Two years of experience with Medicare billing or Medicare related billing functions is strongly preferred.
• Must be able to communicate effectively.
• Must be well organized and able to manage time efficiently.
• Must work well with minimal supervision and have strong work ethic.

Additional Information

Compensation = $17 - $20 per hour

Enhabit Home Health & Hospice is an equal opportunity employer. We work to promote differences in a collaborative and respectful manner. We are committed to a work environment that supports, encourages and motivates all individuals without discrimination on the basis of race, color, religion, sex (including pregnancy or related medical conditions), sexual orientation, gender identity, marital status, age, disability, national or ethnic origin, military service status, citizenship, genetic information, or other protected characteristic. At Enhabit, we celebrate and embrace the special differences that makes our community extraordinary.

No deadline (Indefinite) - Ongoing Recruitment