Quality Assurance Specialist Addison TX Full Time
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 (QA) Specialist – Account Support Team (AST) is to ensure data quality, standardization, accuracy and integrity for client data. The QA Specialist - AST 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 improvement plans via immediate coaching and/ore creating/updating operating procedures and workflows.
Review the Operations New Account Creation Queue validating the creation of a new account based on the data provided and determining appropriate action
Run duplicate creation report and meet with colleague to understand request and track results to upper leadership
Run daily C4 report to retrieve any emails that did not convert to cases and convert to case and assign to queue
Maintain the notes database per policy and guidelines, by creating standard notes, reviewing/updating non-standard notes and deleting unused notes
Maintain the contract and employer pricing tool with all pre-approved pricing adjustments referencing contracts; PAR Sales requests, Lab/Third Party Administrators (TPA) emails
Create, execute and maintain spreadsheets to monitor and analyze findings and solutions on client data quality
Engage the existing national Lab/TPA managers directly to understand their business needs and develop business solutions to address those needs
Interact with the Operations, Central Billing Offices (CBOs), and Sales leadership teams to resolve national Lab/TPA pricing, notes and medical record
Provide coaching to colleague(s) when needed
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 required
- College degree preferred
- At least one year of experience in a customer service oriented role
- At least one year of experience in a Concentra Customer Operations frontline role
- Detail oriented
- Excellent verbal and written communication skills
Direct reports: No
Indirect reports: No
Budget responsibility: Not applicable
High School Diploma or GED equivalent
Some college courses in Business Administration or in a related field
One to three years of Quality Assurance experience in healthcare field or
One to three years of 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
The physical demands described here are representative of those that must be met by an employee to perform the essential functions of this job successfully. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work requires full range of body motion including manual and finger dexterity, as well as eye-hand coordination. Sitting for prolonged periods of time. Frequently standing, and walking for prolonged periods of time, as well as occasional bending and stooping. Ability to communicate with employees, vendors, staff and clients. Normal or corrected vision to levels that allow performance of tasks inherent to medical practice and common office work. Hearing within the acceptable range for telephone and in-person contacts. Dexterity of hands and fingers to operate a computer keyboard, mouse, and other devices. The ability to lift up to 10 pounds as required by performing the duties of the position.
Work is performed in an office environment. Involves frequent telephone, in-person, and e-mail contact with clients, staff, vendors, consultants, and Management. Requires the ability to work in a demanding environment and to effectively resolve conflicts as they arise.
The mental demands described here are representative of those that must be met by an employee to perform the essential functions of this job successfully. In this position, the employee may have imposed pressure on a routine and frequent basis to meet various deadlines, contact with people in stressful and unpredictable situations and to handle confidential and sensitive information and situations with care and protecting patient and employee data is critical.
The above statements for physical, mental and working conditions are subject to change based on office, clinical or external/internal factors and environments.
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.
This job requires access to confidential and sensitive information, requiring ongoing discretion and secure information management.
Concentra is an Equal Opportunity Employer M/F/Veterans/Disabled