Job details
Job type full-time number of hires for this role 1
Full job description
The qa specialist is responsible for all review of all revenue cycle management (rcm) qa functionsThe 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 cycleEnsures the rcm team maximizes the collectability of the services performedEnsures that policies and practices support operational quality, efficiency and complianceResponsible for assisting and leading a variety of audit projects within their revenue cycle management departmentWorking 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: $21.00 - $23.00 per hour
Benefits:
Dental insurance
Disability insurance
Health insurance
Life insurance
Paid time off
Vision insurance
Schedule:
Monday to friday
Work location:
Fully remote
Work location: remote
