Sr. Quality Assurance Specialist

Mass General Brigham•Salem, MA

3d•$31 - $45•Hybrid

About The Position

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham. Responsible for ensuring the quality and accuracy of Patient Access Services (PAS) billing and claims processes. Performs quality assurance reviews, analyzes workflows, and collaborates with staff to ensure compliance with billing policies and improve patient access operations. This role will provide oversight of the patient access service training and quality assurance processes to ensure materials are compliant and current with Epic and industry standards. Key areas of focus will include ensuring the quality of registrations across the hospital is meeting benchmarks to eliminate added volume in work queues and ensure efficient claim processing. Actively work in Epic software to review registration errors, authorizations and insurance claim edits. Identifies areas for improvement and develops, implements, maintains, and continuously evaluates the training program for patient access employees. This role will also serve as a subject matter expert and assist with Epic system upgrades and education and re-training of staff.

Requirements

Associate's Degree Healthcare Administration required or Associate's Degree Business required or Associate's Degree Related Field of Study required
Experience in PAS, billing, or quality assurance 2-3 years required
Experience within a healthcare environment 2-3 years preferred
In-depth understanding of PAS billing, claims processing, and quality assurance practices.
Strong analytical skills, with the ability to identify trends and provide actionable insights.
Proficiency in using billing software and data analysis tools.
Effective communication skills, with the ability to train and collaborate with team members.
Detail-oriented with a strong focus on accuracy and compliance.

Nice To Haves

Experience within a healthcare environment 2-3 years preferred

Responsibilities

Designs and evaluates employee training programs to enhance accuracy, efficiency, and compliance.
Conducts quality assurance reviews and audits to ensure compliance and identify improvement opportunities.
Analyzes performance metrics and trends, providing actionable insights and reports to management.
Maintains documentation of QA practices, procedures, and audit outcomes.
Ensures regulatory compliance with federal, state, and organizational policies.
Manages staffing logistics, including shift coverage and monthly scheduling.
Supports timekeeping and approvals in UKG as a designated delegate.
Provides cross-functional and real-time operational support across Patient Access areas, including ED Registration.
Work alongside manager to ensure appropriate staffing and efficient workflows in patient areas.