Quality Assurance Auditor

Baptist Health

6d • Onsite

About The Position

The Quality Assurance (QA) Auditor is responsible for evaluating the accuracy, completeness, and compliance of Patient Access workflows to support high‑quality registration practices and reduce preventable technical denials across Baptist Health. This individual will conduct comprehensive audits, including random reviews, targeted audits based on denial trends, and ongoing monitoring following training interventions, to ensure consistent adherence to organizational policies, payer requirements, and documentation standards. The Auditor will partner with Patient Access leadership, Denials Specialists, and the Training and Education team to identify performance gaps, validate staff competency, and provide actionable feedback that drives continuous improvement. This position may have additional duties assigned that are within scope of the role.

Requirements

• Bachelor’s degree in Business Administration, Healthcare Administration, Health Information Management, or related field required.
• Minimum 3 years of patient access or healthcare revenue cycle experience required.
• Certified Healthcare Access Associate (CHAA), Certified Healthcare Access Manager (CHAM), or Certified Revenue Cycle Specialist (CRCS) required or obtained within 1 year of hire
• Strong understanding of Patient Access workflows, including registration accuracy, financial clearance, insurance entry, and prior authorization.
• Working knowledge of CPT, ICD-10, payer guidelines, medical necessity requirements, and common denial types.
• High attention to detail and ability to identify patterns, trends, and root causes.
• Excellent communication skills and the ability to provide constructive, professional feedback.
• Strong documentation and reporting skills.
• Ability to maintain objectivity and confidentiality.
• Proficiency with EHR/EMR systems, claim scrubbers, and Microsoft Office tools.

Nice To Haves

• Experience in registration, insurance verification, authorization workflows, or denial prevention strongly preferred.
• Prior auditing, quality review, or training/education support experience a plus.

Responsibilities

• Conduct comprehensive audits, including random reviews, targeted audits based on denial trends, and ongoing monitoring following training interventions.
• Ensure consistent adherence to organizational policies, payer requirements, and documentation standards.
• Partner with Patient Access leadership, Denials Specialists, and the Training and Education team to identify performance gaps, validate staff competency, and provide actionable feedback that drives continuous improvement.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level