Personify Health

Audit Supervisor

Job Locations US-Remote
Job ID
2024-3632
Category
Claims Operations
Posted Date
1 month ago(10/23/2024 9:18 AM)
Type
Regular Full-Time

Overview

Now is the time to join us! 

 

We’re Personify Health. We’re the first and only personalized health platform company to bring health, wellbeing, and navigation solutions together. Helping businesses optimize investments in their members while empowering people to meaningfully engage with their health. At Personify Health, we believe in offering total rewards, flexible opportunities, and a diverse inclusive community, where every voice matters. Together, we’re shaping a healthier, more engaged future.

Responsibilities

Who are you?

 

The Audit Supervisor plays a vital role in maintaining the integrity of the claims process. They review internal procedures, processes, and controls to ensure final payments were accurately reflected. Additionally, they analyze claims data to identify incorrectly paid claims and work with the claims department to get the claims corrected, assist with identifying training needs and manage the quality assurance team.

 

In this role you will wear many hats, but your knowledge will be essential in the following:  

  • Record/track quality assessment scores and provide feedback to applicable departments in order to reduce errors and improve processes and performance.
  • Monitors performance results and supports efforts to develop and implement changes to improve the process.
  • Meet established time frames for performance guarantees.
  • Reviews the accuracy of the quality assurance team.
  • Works with leadership teams to establish a highly effective internal audit program.
  • Manages client performance guarantees and provides results to clients.
  • Meets with clients on performance guarantees (in person or via virtual meetings)
  • Identify defects and improve departmental performance by supporting quality, operational efficiency, and production goals.
  • Assist with document control development related to the quality assurance system.
  • Provide support to quality assurance auditors as needed.
  • Formulates and maintains department key performance measurements and reports to department management.
  • Ensure the privacy and security of PHI (Protected Health Information) as outlined in the department policies and procedures relating to HIPAA Compliance.
  • Ensure the privacy of quality assurance statistics for the claim’s examiner results.
  • Foster good corporate relations by practicing good customer service principles (i.e., positive attitude, helpful, etc.)
  • Complete any other tasks assigned by the Manager.

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.

Qualifications

What you bring to the Personify Health team:

 

In order to represent the best of what we have to offer you come to us with a multitude of positive attributes including:

  • Knowledge of medical terminology; ICD-9, CPT & HCPCS coding.

  • Good time management skills; highly organized, detail-oriented, with extreme accuracy.

  • Effective and professional communication ability, written and verbal skills.

  • High school graduation or equivalent (GED).

  • Quality assurance experience.

  • Demonstrate ability to work independently with excellent judgment

  • Ability to organize, prioritize, and multitask in a fast-paced/deadline driven environment.

  • Proficient in Word, Excel, and Outlook.

  • 1 year of supervisor experience managing employees.

  • 2 years Healthcare/Medical claims processing experience.

  • Ability to meet with clients and present audit results.

No candidate will meet every single desired qualification. If your experience looks a little different from what we’ve identified and you think you can bring value to the role, we’d love to learn more about you!

 

Personify Health is an equal opportunity organization and is committed to diversity, inclusion, equity, and social justice.

 

In compliance with all states and cities that require transparency of pay, the base compensation for this position ranges from $52,000 to $62,000. Note that salary may vary based on location, skills, and experience. This position is eligible for health, dental, vision, mental health and other benefits.

 

We strive to cultivate a work environment where differences are celebrated, and employees of all backgrounds are empowered to thrive. Personify Health is committed to driving Diversity, Equity, Inclusion and Belonging (DEIB) for all stakeholders: employees (at each organization level), members, clients and the communities in which we operate. Diversity is core to who we are and critical to our work in health and wellbeing.

 

#WeAreHiring #PersonifyHealth

 

Beware of Hiring Scams: Personify Health will never ask for payment or sensitive personal information such as social security numbers during the hiring process. All official communication will come from a verified company email address. If you receive suspicious requests or communications, please report them to talent@personifyhealth.com. All of our legitimate openings can be found on the Personify Health Career Site.

 

Application Deadline: Open until position is filled.

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