The purpose of the Quality Assurance Specialist position is to help drive quality and productivity within the Revenue Cycle and will serve as a subject matter expert with regards to revenue cycle systems used in the department. The Quality Assurance Specialist will specifically focus on adherence to all billing compliance policies and maintain strict oversight of government and commercial payer requirements as well as review insurance and denials management processes. In addition assure quality, accuracy, and timeliness standards are maintained including claim and account details. This will be done through designed process audits, written reports and analysis of the reports as needed. Work products and outputs will include detailed audits and reports to identify process and quality deficiencies, analysis and recommended plans of actions to improve audited processes, as well as establish educational resource and reference materials as appropriate to support the department as a direct outcome of quality assurance review findings. The Quality Assurance Specialist will assist Management in routine reviews of policies and procedures and the implementation of improvement plans as needed.
- 1-2 years Customer Service Experience
1-2 years Medical Billing Experience
1-2 years Insurance Billing Experience
Knowledge base in ICD-10 and CPT4/HCPCS