Quality Assurance Coordinator - Greenville SC at Vinea Capital Inc – Greenville, South Carolina

We are looking for excited, motivated, and mission-minded individuals to join our team as Quality Assurance Coordinator - Greenville SC!

At ABLE Kids, we value customer service and professionalism while providing excellent therapy. We strive to ensure that our clients and their families feel valued and loved. We like to think outside the box and are eager to adapt the pediatric care experience to the unique needs of children.

Responsibilities:

• Review eligibility weekly (insurance approvals, changes, authorization updates).
• Review authorization approvals vs. weekly hours weekly (ensure no changes, or adjust hours to appropriate changes).
• Upload audits to designated insurance provider's request. (cc: COO, QA Director, Billing)
• Assist in finding errors in EMR, reporting to the Case Manager/BCBA for designated clinic and follow up on corrections.
• Updates sent to QA Director weekly. To include reporting daily numbers and approved hours per clinic, expiring authorization follow ups, and new (increased) authorized hours and reference to clinic numbers.
• Answer phone calls and route to the correct clinic.
• Request maintenance needs for clinics as appropriate.
• Monitor emergency drills quarterly, check fire extinguishers monthly, check/balance of submission
• Review concurrent billing, address all "double” billing issues, email QAD to delete billing as necessary.
• Follow up every 6 months for new authorizations on EMR. Ensure timely submission, 60 days prior to authorization expiration.
• Update Client grid as appropriate for authorization expiration (Outreach-> BCBA-> QAC)
• Communicate with BCBA when new authorization is uploaded in EMR.
• Ensure all new authorizations are uploaded and coded correctly within EMR.

Position Requirements:

• High School Diploma. Associates degree or higher preferred.
• Medical authorization experience a plus.
• Knowledge of EMR systems a plus.
• Must love to work with children.
• Able to communicate clearly with clients in person and over the phone.
• Must value customer service and working as part of a team.
• Travel 25% or more in the region, and periodically to corporate office.
• Reliable transportation

Hours & Structure

• Be ready to go by 8:00 AM sharp. Wrap up your day by 4:30 PM.
• This position Reports directly to the Quality Assurance Director.
• Work Location & Presence: We are an in-office team.
• Dress Code: Professional casual (jeans, shorts, skirts, t-shirts, polos, blouses). Closed-toe shoes only.

We offer GREAT benefits including Medical, Dental and Vision insurance, a FREE $50k life insurance policy, 120 hours of PTO annually, a 401k with up to a 4% employer match, and 6 paid holidays per year.