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Quality Audit Associate - Remote

Paradigm

Location: Tampa, Florida
Type: Remote
Posted on: October 5, 2021
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Description
Paradigm is an accountable care management organization focused on improving the lives of people with complex and catastrophic injuries and diagnoses. We have been a pioneer in value-based care since 1991, offering deep clinical expertise, high-value specialty networks, behavioral health support, payment integrity solutions, and robust data analytics to generate the very best outcomes for patients, payers, and providers.
Paradigm is headquartered in Walnut Creek, California, with offices across the U.S. For more information, please visit www.paradigmcorp.com.
The Quality Auditor will provide administrative support to the SPU Managers and Supervisors.
Requirements
• Remote position
• Knowledge of and adherence to account guidelines.
• Completes case billing audits in accordance to specific account guidelines.
• Completes daily audit quota as defined by SPU Managers.
• Navigates through customer specific software systems with accuracy and attention to detail.
• Researches and investigates short pays, non-pays and documents appropriately in collections application.
• Performs internal audits as required by SPU customers.
• Running queries, calibrates with customer specific data to insure accuracy.
• Provides case permissions as requested on files.
• Performs additional tasks assigned by managers or supervisors.
• Responsible for complying with Paradigm IT security requirement and policies.
• Responsible for safeguarding Paradigm or Paradigm related IT passwords.
• Responsible for notifying Paradigm of any IT security incidents per policy 16.0 Information Security Incident Management.
Qualifications:
• High School Diploma, Post-secondary education preferred.
• Excellent computer skills and knowledge of proprietary company software, Outlook and Excel.
• Operate office machinery including but not limited to: computers, faxes, printers, phones.
• Strong interpersonal communication skills, both verbal and written.
• Works collaboratively with all team members.
• Strong attention to detail, organizational skills as well as ability to multitask and prioritize.
• Exercise judgment and maintain confidentiality.
• Ability to work independently.
• Critical thinking / problem solving skills
PM19