At ZOLL, we're passionate about improving patient outcomes and helping save lives. We provide innovative technologies that make a meaningful difference in people's lives. Our medical devices, software and related services are used worldwide to diagnose and treat patients suffering from serious cardiopulmonary and respiratory conditions.

The Acute Care Technology division of ZOLL Medical Corporation develops and delivers innovative lifesaving products and software solutions to EMS, hospital, public safety, and military customers globally. Products include AEDs, trauma kits, ventilators, temperature management solutions, and more. Our dedicated employees take pride in their commitment to improving patient outcomes while delivering world-class customer service.

Job Type

Remote

Job Summary

Under the general direction of the RCM Compliance Director, the Quality Assurance Project Manager will organize, evaluate, and complete documentation reviews for Medicare-enrolled providers. This role involves identifying deficiencies in documentation based on Medicare guidelines and conducting auditing and monitoring activities of daily operational processes. The position requires an analytical mindset and the ability to communicate findings with all levels of leadership, ensuring process efficiency and data validation.

Essential Functions

• Conduct customer documentation audits, review CERT/ADR, and manage customer deliverables, using critical thinking skills to identify areas of concern.
• Establish and maintain positive and productive relationships with office staff and customers, using discretion in all interactions.
• Perform and manage internal compliance audits focused on operations and the latest OIG projects, providing and maintaining a scoring scale based on independent analysis.
• Use professional judgment to provide training related to ambulance operations, including crew documentation, Scope of Practice Management, Dispatch Protocols, and Signature Documents.
• Apply independent interpretation of guidelines as they pertain to each state.
• Audit customer documentation and monitor operational processes, using autonomous decision-making to ensure compliance with federal regulations.
• Prepare analysis and use data to plan, organize, manage, and control Revenue Cycle Management processes, exercising significant independent judgment in data interpretation and strategic planning.
• Interact with customer administration, crew members, managed care contracting agencies, law enforcement, and hospital patient information systems to review compliance events.
• Pinpoint system misalignments, data inaccuracies, and team communication gaps. Report key issues to leadership.
• Audit and monitor customer documentation, level of service and diagnosis assignments, compliance with signature document completion, and process compliance.
• Assess the utilization of software products during internal reviews.
• Ensure billing requirements are met and customers are aware of documentation requirements set by Medicare, Medicaid, and other payers.
• Collaborate with customers to analyze various fields of their ePCR, providing comprehensive feedback and suggestions for documentation and software use.
• Provide thoughtful and precise scoring, comments, and feedback to foster partnership and trust.
• Offer comprehensive feedback, process improvement, and education during internal monitoring of staff decisions.
• Investigate ancillary findings revealed during observations.
• Provide factual observations.
• Report accurate error and accuracy rates.
• Deliver comprehensive summaries of reviews.
• Maintain professional customer interactions, communicating areas requiring improvement, the reasons, and the methods.

Required/Preferred Education and Experience

• High School Diploma required
• 4-6 years of experience in medical billing/collections in a medical office, clinical site, or billing/collections office required
• Maintain active membership with the National Academy of Ambulance Compliance (NAAC) and other relevant certifications (e.g. CACO, CAPO, CAC, CADS). Required
• Medical billing and coding certificate and clinical degree Preferred

Knowledge, Skills and Abilities

• Maintain a presentable personal appearance.
• Communicate effectively with all levels of management, customers, and staff.
• Provide written communication using best business practices for letters, memorandums, and emails.
• Read, write, comprehend, and interpret policies, procedures, and regulations.
• Multi-task and meet deadlines efficiently.
• Be extremely organized, detail-oriented, and resourceful.
• Solve problems proactively.
• Plan and carry out responsibilities with minimal direction.
• Produce accurate work and verify information before use or dissemination.
• Adhere to all company safety, compliance, business ethics, and privacy regulations.
• Show initiative in learning company organization and procedures.
• Represent the company positively to employees, customers, agencies, entities, and patients.
• Experience with software development, design, and training.
• Knowledge of general office procedures and office equipment.
• Proficiency in Microsoft Office Word and Excel, including pivot tables and revenue cycle metrics.
• Experience with Hospital Systems (e.g., EPIC, Cerner) and Salesforce is a plus.
• Utilize PC, including Golden Hour proprietary software, and be proficient in Excel and other Microsoft tools and standard office equipment.

Preferred Languages

• English - Expert

Travel Requirements

• 5%

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

• Standing - Occasionally
• Walking - Occasionally
• Sitting - Constantly
• Talking - Occasionally
• Hearing - Occasionally
• Repetitive Motions - Frequently

Compensation for this position is $75K-$80K. Final compensation will be determined by various factors such as a candidate's relevant work experience, skills, certifications, and location.

If you would like to be considered for this role, we are asking that all applicants please apply by the end of the dayon Friday, January 31, 2025.

ZOLL is a fast-growing company that operates in more than 140 countries around the world. Our employees are inspired by a commitment to make a difference in patients's lives, and our culture values innovation, self-motivation and an entrepreneurial spirit. Join us in our efforts to improve outcomes for underserved patients suffering from critical cardiopulmonary conditions and help save more lives.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.