Pre-Bill QA Specialist

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities. Come Join Our Team As part of our robust Rewards & Recognition program, this role is eligible for our Ventra performance-based incentive plan, because we believe great work deserves great rewards. Help Us Grow Our Dream Team — Join Us, Refer a Friend, and Earn a Referral Bonus Job Summary As a Pre-Bill Quality Assurance (QA) Specialist, you will play a crucial role in ensuring the accuracy and integrity of patient demographic data and charge entry within the healthcare system. Your responsibilities will include meticulous data entry, thorough quality assurance checks, and adherence to regulatory standards to support the efficiency and reliability of healthcare billing processes. Essential Functions And Tasks Data Entry: Accurately input patient demographic information into the healthcare database system. Enter charges for medical services rendered by healthcare providers according to established procedures and coding standards. Ensure timely completion of data entry tasks to support billing processes and reimbursement. Quality Assurance: Conduct thorough quality checks on demographic data and charge entry to identify discrepancies, errors, or inconsistencies. Verify the accuracy of patient information, including insurance details, contact information, and medical history. Review charge entries for completeness, accuracy, and compliance with coding guidelines and billing regulations. Documentation and Reporting: Maintain detailed documentation of data entry and quality assurance activities. Generate reports on data entry accuracy, charge entry errors, and quality assurance findings. Communicate findings to relevant stakeholders, including billing managers, healthcare providers, and administrative staff. Compliance and Regulation: Stay updated on healthcare regulations, coding standards, and billing requirements. Ensure compliance with HIPAA regulations and other data protection laws in handling patient information. Implement best practices for data entry and charge entry to minimize errors and mitigate compliance risks. Collaboration and Communication: Collaborate with other healthcare administrative staff to resolve data discrepancies and address billing issues. Communicate effectively with billing teams, coding specialists, and healthcare providers to ensure accurate and timely billing processes. Provide support and guidance to colleagues on data entry procedures and quality assurance standards. Education And Experience Requirements Bachelor's degree in any related field. Proven experience of minimum 4 years in providing support in healthcare data entry, medical billing. Knowledge, Skills, And Abilities Proficiency in using healthcare database systems and billing software. Knowledge of medical terminology, CPT codes, and ICD-10 coding standards. Attention to detail and strong analytical skills to identify errors and discrepancies. Excellent organizational and time management abilities to meet deadlines and manage multiple tasks. Strong communication skills, both written and verbal, for effective collaboration and reporting. Familiarity with HIPAA regulations and healthcare compliance standards. Certification in medical billing and coding (e.g., CPC, CCS) is a plus. Compensation Base Compensation will be based on various factors unique to each candidate including geographic location, skill set, experience, qualifications, and other job-related reasons. This position is also eligible for a discretionary incentive bonus in accordance with company policies. Ventra Health Equal Employment Opportunity (Applicable only in the US) Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions. #J-18808-Ljbffr