Quality Assurance Associate - Medical Bill Review

Are you looking for an opportunity to join a fast-growing company that has consistently outpaced the industry in year-over-year growth? Liberty Mutual offers an exciting opportunity for a Quality Assurance Associate within our Workers' Compensation – Medical Bill Review department!
 
The Quality Assurance (QA) Associate under moderate supervision, is responsible for reviewing medical bills and administrative tasks to ensure quality assurance and providing direct feedback or coaching to Medical Service Representatives (MSRs). This role requires the use of bill review skills, medical bill review administrative skills, and adherence to standard procedures to ensure that medical bill review tasks are performed to standard and are in accordance with established rules and guidelines.
 
To be considered for this role, candidates should have experience in Medical Bill Review. While a California Certification is preferred, it is not mandatory at the time of application. Candidates without this certification will be required to obtain it within a specified timeframe after being hired.
 
This position is remote, but we prefer candidates to be situated close to our claims office in Suwanee, GA. If you live within 50 miles of the office, you will be required to report to the office twice a month. Please note this policy is subject to change.
 
Responsibilities

• Review medical bills and administrative tasks per standard work.
• Evaluate medical bills and administrative tasks by comparing them to predefined best practices and assessing the correctness and completeness of the information provided.
• Provide support for internal audits and focus audit requests to support various stakeholders.
• Assist in identifying areas for training development and automation.
• Participate in Quality Assurance Calibration sessions.
• Conduct periodic audit reviews to ensure compliance with department protocols.
• Assist with the development and/or refinement of standard work, including Pathway Rules and Inkling instructions.
• Effectively communicate complex medical bill review situations to a variety of stakeholders with different backgrounds to achieve desired communication/outcome, and other duties assigned.

• Associates degree or equivalent training
• 3 years experience required, with 1-2 years Quality assurance or related insurance experience.
• Must possess strong interpersonal and persuasive skills in order to communicate effectively.
• Insurance licenses may be required.
• Insurance product, policy, systems, claims and coverage knowledge preferred.
• Strong oral and written communications skills are required.