QA Specialist, HME - San Antonio, TX
Do you have compassion and a passion to help others? Transforming healthcare and millions of lives as a result starts with the values you embrace and the passion you bring to achieve your life’s best work.(sm)
The Quality Assurance specialist, with the assistance of other QA Specialist(s), performs concurrent 100% record reviews for compliance of federal and state rules and regulations and agency policies; monitors factors which directly and indirectly influence the billing and payment for the care rendered to the Agency’s patients.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
This position requires the ability to maintain confidentiality of all incoming personal and private information, no exceptions.
- Performs 100% record reviews for compliance of federal and state rules and regulations and agency policies; monitors factors which directly and indirectly influence the billing and payment for the care rendered to the Agency’s patients
- Reviews that all needed information is in the Sales Order (i.e., demographics, clinicals, correct insurance, correct procedure codes, eligible diagnosis, etc.)
- Reviews Delivery Tickets against the information in the computer (Brightree) to make sure items are billed correctly, and that the required documentation has been procured and scanned into Brightree for all branches
- Assists with entering orders into Brightree from physician’s orders for DME Closets from all branches and performs the 100% record review on these orders
- Assists in reviewing and confirming Pickup/Exchange tickets from all branches except for San Antonio
- Demonstrates effective written and verbal communication
- Complies with all agency policies and procedures. Promotes and maintains agency environment that is in compliance with federal, state, and local regulatory guidelines
- Participates in personal professional growth and development
- Demonstrates flexibility, enthusiasm and willingness to cooperate while working with others or in place of others as necessary
- Performs other duties as assigned
- Maintain privacy and confidentiality with regard to all patient, staff & agency information
- Problem solving Skills
- Interpersonal Skills
- Communication Proficiency (Oral & Written).
- Project & Time Management Skills
- Ethical Conduct - follows appropriate chain of command
- Adaptability & Dependability
- Safety & Security
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Ability to work in a stressful environment. Positive work environment is promoted for all agency employees. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus. This job operates in a professional office environment. This role routinely uses standard office equipment.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Position Type/Expected Hours of Work
Employee must be available during the “core” work hours, which is 7:30am until 4:30pm for this department, and must work 40 hours each week to maintain full-time status
No Travel is expected for this position.
You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.
- 2+ years of experience in Home Medical Equipment
- Experience with Brightree Electronic Records program
- Ability to operate computer terminal, printer, fax and copier machines
- Knowledge of general office procedures
- Excellent computer skills and knowledge of word processing and excel
- Good organization, communication, human relations skills
- Self-motivation, assertiveness and independent decision-making skills are essential
- Must be able to read and follow written and verbal instructions in English effectively
- Full COVID-19 vaccination is an essential job function of this role. Candidates located in states that mandate COVID-19 booster doses must also comply with those state requirements. UnitedHealth Group will adhere to all federal, state and local regulations as well as all client requirements and will obtain necessary proof of vaccination, and boosters when applicable, prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation
Homecare Dimensions provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Homecare Dimensions complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
Homecare Dimensions expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Homecare Dimensions’ employees to perform their job duties may result in discipline up to and including discharge.
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
To protect the health and safety of our workforce, patients and communities we serve, UnitedHealth Group and its affiliate companies require all employees to disclose COVID-19 vaccination status prior to beginning employment. In addition, some roles and locations require full COVID-19 vaccination, including boosters, as an essential job function. UnitedHealth Group adheres to all federal, state and local COVID-19 vaccination regulations as well as all client COVID-19 vaccination requirements and will obtain the necessary information from candidates prior to employment to ensure compliance. Candidates must be able to perform all essential job functions with or without reasonable accommodation. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment
Careers with WellMed. Our focus is simple. We're innovators in preventative health care, striving to change the face of health care for seniors. We're impacting 550,000+ lives, primarily Medicare eligible seniors in Texas and Florida, through primary and multi-specialty clinics, and contracted medical management services. We've joined Optum, part of the UnitedHealth Group family of companies, and our mission is to help the sick become well and to help patients understand and control their health in a lifelong effort at wellness. Our providers and staff are selected for their dedication and focus on preventative, proactive care. For you, that means one incredible team and a singular opportunity to do your life's best work.(sm)
WellMed was founded in 1990 with a vision of being a physician-led company that could change the face of healthcare delivery for seniors. Through the WellMed Care Model, we specialize in helping our patients stay healthy by providing the care they need from doctors who care about them. We partner with multiple Medicare Advantage health plans in Texas and Florida and look forward to continuing growth.
Diversity creates a healthier atmosphere: UnitedHealth Group is an Equal Employment Opportunity/Affirmative Action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.
UnitedHealth Group is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.