Healthcare Quality Assurance Specialist (SCA)

ABOUT PERFORMANT:

At Performant, we’re focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Through this important work we accomplish our mission: To offer innovative payment accuracy solutions that allow our clients to focus on what matter most – quality of care and healthier lives for all.

If you are seeking an employer who values People, Innovation, Integrity, Fun, and fostering an Ownership Culture – then Performant is the place for you!

ABOUT THE OPPORTUNITY:

In Office position (Only)

Under general supervision the Healthcare Quality Assurance Specialist (SCA) provides support to the departmental quality assurance program. This position is responsible for performing the full range of quality assurance duties, working independently, and exercising judgment and initiative. Positions at this level receive occasional instruction or assistance as new or unusual situations arise and are fully aware of the operating procedures and policies of the work unit. Exercises no direct supervision over staff.

Key Responsibilities:

The duties listed below are intended only as illustrations of the various types of work that may be performed. The omission of specific statements of duties does not exclude them from the position if the work is similar, related or a logical assignment to this position.

• Quality reviews work assignment tasks related to specific departmental workflows.

• Uses available tools to gather data and analyze trends or patterns affecting quality; highlights key successes and shares best practices with staff to ensure continued success in quality of tasks/service performance.

• Responsible to identify areas of improvements and collaborate with departmental leadership team members to identify and streamline processes and implement processes that enhance the company’s standards of work performance and the customer experience.

• Provides structured and timely recommendations through verbal and/or written feedback to leadership team.

• Provides direct individual coaching/feedback to team members using specific examples highlighting positive and negative trends which identify performance strengths as well as areas of improvement needed.

• Develops and conducts targeted group coaching sessions that address quality deficiencies and/or improvement opportunities.

• Assists with creation of training materials and performs related duties as assigned.

• Assesses new hires after training has been completed to determine readiness for moving into support.

• Observes and complies with all company and mandated rules, regulations, and protocols.

• Selects a quality sample for assigned staff members, conducts timely QA reviews based on outlined criteria, enters QA results into tool.

• Runs QA reports summarizing results of QA conducted by staff members, team and department.

• Follows Quality standard operating procedures.

• Performs other duties as assigned.

Knowledge, Skills, and Abilities Needed:

• Strong soft skills: ability to interact effectively and constructively with others

• Outstanding written and verbal communication skills

• Good critical thinking, questioning, and listening skills; excellent attention to detail

• Problem-solving and task management skills

• Time management skills for managing multiple tasks simultaneously, while completing work within allocated time frames

• Ability to handle changing situations and work within a diverse group

• Ability to work independently but also as a member of a team.

• Ability to meet objectives with minimal supervision

• Strong technical skills are desired

Required and Preferred Qualifications:

• Ability to obtain and maintain client required clearances as well as pass company regular background and/or drug screening.

• High School Diploma or GED is required.

• Completion of Teleworker Agreement upon hire, and adherence to the Agreement (and related policies and procedures) including, but not limited to: able to navigate computer and phone systems as a user to work remote independently using on-line resources, must have high-speed internet connectivity, appropriate workspace able to be compliant with HIPAA, safety& ergonomics, confidentiality, and dedicated work focus without distractions during work hours.

WHAT WE OFFER:

Performant offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, 11 paid holidays per year, as well as sick time and vacation time off annually. For more information about our benefits package, please refer to our benefits page on our website or ask your Talent Acquisition contact during an interview.

Physical Requirements & Additional Notices:

If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required.  Proof of such may be required prior to an offer being made.  It is the Employee’s responsibility to maintain this Internet access at their home office location.

The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary.

• Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse.

• Regularly reads and comprehends information in electronic (computer) or paper form (written/printed).

• Regularly sit/stand 8 or more hours per day.

• Occasionally lift/carry/push/pull up to 10lbs.

Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position:

• Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions).   Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions.

• Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists.

• Must complete the Performant Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures.

• Other requirements may apply.

All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times.  Violations to Performant’s policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.

Performant is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Performant will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Performant’s Human Resources team to discuss further.

Our diversity makes Performant unique and strengthens us as an organization to help us better serve our clients. Performant is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.

THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED