Healthcare Quality Assurance Analyst

5 days ago


Dallas, Texas, United States CalpionPlutus Health Full time
About the Role:
Plutus Health Inc. is a leading provider of Revenue Cycle Management (RCM) services with SOC2 Certification. We're seeking a highly skilled Quality Control Analyst to join our team, focusing on ensuring compliance with healthcare regulations and industry standards for SUD services. The ideal candidate will have a strong understanding of SUD coding practices and a commitment to maintaining high-quality audit standards.

Responsibilities:
  • Conduct thorough audits of accounts receivable and coding practices specific to SUD services.
  • Review and analyze medical records to assess coding accuracy for SUD-related treatments and procedures.
  • Provide constructive feedback and guidance on SUD-specific coding standards and best practices.
  • Generate and present audit reports highlighting areas for improvement and trends in coding and billing practices.
  • Collaborate with revenue cycle management teams to address coding discrepancies and AR issues related to SUD services.

Requirements:
  • Bachelor's degree in healthcare, business administration, or a related field preferred.
  • Minimum 2-3 years of experience in healthcare coding, billing, or quality control analysis, with specific experience in SUD settings.
  • Strong knowledge of ICD-10, CPT, and HCPCS coding systems, particularly as they relate to SUD services.
  • Familiarity with AR processes and revenue cycle management specific to behavioral health.
  • Excellent analytical skills and meticulous attention to detail.
  • Strong communication and interpersonal skills, with the ability to collaborate effectively with diverse teams.

Compensation:
  • $80,000 - $105,000 annual salary, depending on experience.
  • Comprehensive health benefits (medical, dental, vision).
  • Paid time off and flexible work arrangements.
  • Opportunities for professional development and career growth.


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