Concentra Quality Assurance Specialist I
From our Dallas corporate headquarters to our clinics and worksite locations, Concentra colleagues remain focused on our driving purpose: to provide superb patient and employer experience by delivering the highest quality healthcare in an efficient, affordable, caring manner. We do this by putting all customers (internal and external) first and by displaying:
- A healing focus
- A selfless heart
- A tireless resolve
The primary focus of the Quality Assurance Specialist – Customer Success Group (QA-CSG) is to ensure data quality, standardization, accuracy and integrity for client data. The QA Specialist works with Payor Sales, Account Support, Operations, Information Systems, Strategic Planning and Concentra Central Billing Office Directors, ensuring accurate data is existing for payer/employer pricing and notes database. Providing continuous tracking and trending of data quality metrics to improve date integrity enterprise wide.
• Review of recently completed account set up and/or account updates to validate the data was entered appropriately and take action to correct if applicable.
• Review duplicate account creation report, along with other reports created for data quality assurance and take action to correct and protect the integrity of the data
• Maintain the notes database per policy and guidelines, by creating standard notes, reviewing/updating non-standard notes and deleting unused notes
• Ensures appropriate use the contract and employer pricing tool with all pre-approved pricing adjustments referencing contracts; PAR Sales requests, Lab/Third Party Administrators (TPA)set up emails
• 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.
• High School Diploma or GED equivalent
• Some college courses in Healthcare, Business Administration or in a related field from an accredited college or university
• Customarily has at least one or more years of demonstrated Quality Assurance experience in healthcare field, and/or demonstration of strong analytics skills experience.
• Customarily has at least one or more years of demonstrated healthcare experience
• Working knowledge of Microsoft Access and excel (vlookups and pivot tables)
• Concentra Core Competencies of Service Mentality, Attention to Detail, Sense of Urgency, Initiative and Flexibility
• Ability to make decisions or solve problems by using logic to identify key facts, explore alternatives, and propose quality solutions
• Outstanding customer service skills as well as the ability to deal with people in a manner which shows tact and professionalism
• The ability to properly handle sensitive and confidential information (including HIPAA and PHI) in accordance with federal and state laws and company policies
• Strong ability to work in a team environment, as well as independently when required
• Strong interpersonal and communication skills a must; ability to read, write, and speak in a professional manner
• Excellent analytical and problem-solving skills are essential
• Demonstrated working knowledge of Microsoft Office Tools; specifically Access and Excel (must be able to perform (vlookups and pivot tables), Outlook, Word
Concentra provides equal employment and affirmative action opportunities to applicants and employees without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, pregnancy, protected veteran status, disability, or other protected categories. In addition, Concentra Inc. complies with applicable state and local laws prohibiting discrimination in employment in every jurisdiction in which it maintains facilities.