Quality Assurance Specialist

Job Summary

A company is looking for a Revenue Cycle Multi-Specialty Quality Assurance Specialist.

Key Responsibilities

• Conduct routine audits of end-to-end process assignments to ensure compliance with SOP/guidelines
• Evaluate eligibility verification, pre-authorization processes, basic coding, charge entry, and billing accuracy
• Identify trends and root causes related to denials and collaborate with management on process improvement plans

Required Qualifications

• High school diploma or equivalent
• 3 or more years of end-to-end revenue cycle operations experience
• Adequate knowledge of all functions in the revenue cycle
• Experience with payer rules, Medicare, Medicaid, and commercial managed care
• Experience with EMR systems such as EPIC, e-clinical works, and Meditech