RCM Quality Assurance Specialist
New
J
JobgetherHealthcare Revenue Cycle
Based in United StatesFull-TimeMiddle
Salary not disclosed
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Job Details
- Experience
- 5+ years of experience in RCM quality assurance auditing, training, or a related healthcare revenue cycle role preferred.
- Required Skills
- Data AnalysisQuality Assurance
Requirements
- High School diploma or GED required.
- Associate degree in Health Information Technology (RHIT) or related field preferred.
- 5+ years of experience in RCM quality assurance auditing, training, or a related healthcare revenue cycle role preferred.
- Strong understanding of RCM billing systems and healthcare revenue cycle processes.
- Experience reviewing documentation, identifying discrepancies, and analyzing quality trends.
- Strong computer skills, including the ability to navigate multiple systems and screens efficiently.
- Excellent attention to detail and ability to identify process improvement opportunities.
- Strong communication skills with the ability to provide clear feedback and collaborate with different teams.
- Ability to work independently, manage priorities, and maintain accuracy in a remote environment.
Responsibilities
- Perform daily audits of RCM accounts to ensure accuracy and compliance with established quality policies and procedures.
- Review documentation, billing records, and account activity to identify errors, missing information, and process gaps.
- Maintain detailed records of quality findings and prepare monthly summary reports for management review.
- Communicate quality issues and provide constructive feedback to staff and department leaders.
- Identify recurring errors, trends, and deficiencies to support process improvements and training initiatives.
- Collaborate with department leadership to review workflows, optimize procedures, and improve operational efficiency.
- Support employee training activities by providing QA insights, guidance, and feedback.
- Monitor trends related to missing documentation, denials, payer issues, system challenges, and other key RCM performance indicators.
- Escalate potential operational, system, or staff-related issues to appropriate leadership teams.
- Respond to inquiries from internal departments and provide quality-related support.
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