Quality Assurance Specialist

Job Summary

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

Key Responsibilities

• Conducts routine audits of end-to-end process assignments to ensure proper SOP/guidelines are met
• Evaluates eligibility verification and pre-authorization processes
• Identifies trends, root causes, and system issues related to denials, no response, or underpayments

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, commercial, and managed care
• Experience with EMR systems