Job description

The QA Specialist is responsible for all review of all Revenue Cycle Management (RCM) QA functions. The QA Specialist develops an environment and culture that embraces continuous improvement and innovation to ensure USPI achieves best practice in all areas of the revenue cycle. Ensures the RCM team maximizes the collectability of the services performed. Ensures that policies and practices support operational quality, efficiency and compliance. Responsible for assisting and leading a variety of audit projects within their Revenue Cycle Management department. Working closely with the Director and Managers to report findings and suggest improvements to internal processes by analyzing data.

Job duties include, but are not limited to:

• Ability to meet assigned deadline and work under minimal supervision and with all levels of staff and management

• Accountable for analyzing and measuring results of implemented policies, changes and system modifications

• Assist in establishing, updating, and communicating new and existing policy and procedures

• Compile data, perform audit, interpret and report back results to management team

• Completes quality audits to ensure RCM employees are providing the highest quality of work

• Conducts Audit-the-Auditor claim audits for procedural and financial accuracy

• Ensure claims are adjudicated in compliance with provider contract parameters, member demographic information, and service level requirements through random and targeted claim reviews

• Establish and implement interim workaround solutions as needed and communicates to all impacted users

• Participate in documenting and prioritizing potential solutions to issues & fallout for system issues

• Proactive communication with the RCM Director on practice data, issues and KPIs that are meaningful to our centers.

• Provide monthly/quarterly/yearly feedback used for client report cards and company Key Performance Indicators (KPI) Required Skills

Job Requirements:

• 3 years of previous Revenue Cycle Management in a healthcare setting, Hospital business processes preferred

• Bachelor’s Degree in Business or Healthcare Administration preferred: or equivalent management background experience

• Demonstrates competence in leadership skills to develop and implement organizational strategies and opportunities for improving hospital growth

• Effective English communication skills, both written and verbal

• Expert level experience with Microsoft Office Products- ability to create and build spreadsheets and reports in Excel

• Knowledge of medical terminology, CPT codes, and ICD-10 codes preferred • Maintain current knowledge and adhere to appropriate regulatory standards such as Government Required Experience

• Maintain current knowledge and adhere to appropriate regulatory standards such as Government

Job Type: Full-time

Pay: From $50,000.00 per year

Benefits:

• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Employee discount
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Vision insurance
• Work from home

Schedule:

• Monday to Friday

Experience:

• Medical Billers & Coders: 1 year (Preferred)
• ICD-10: 1 year (Preferred)

Work Location: Remote

colinoncars.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, colinoncars.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, colinoncars.com is the ideal place to find your next job.