RCM Quality Assurance Specialist

AMSURG • Nashville, TN

7d • Remote

About The Position

The Quality Assurance Specialist in the RCM department will review the quality of records, provide reconciliation analysis utilizing internally developed norms and criteria. The Quality Assurance Specialist will also have specialized QA functions as described below.

Requirements

• High School diploma or general education degree (GED) required.
• Five (5) + years related RCM QA audit experience and/or training; or equivalent combination of education and experience preferred.
• Working knowledge of RCM billing system.
• Good computer skills including the ability to be on multiple screens at once as well as use the zoom in and zoom out feature.

Nice To Haves

• Associate degree in RHIT preferred

Responsibilities

• Daily auditing of RCM account worked by staff to ensure accuracy based on QA policies and procedures.
• Gather of general documentation issues for the purpose of educational feedback.
• Document and maintain QA findings on appropriate Complete monthly summary reports based on daily findings and distribute them to appropriate management personnel.
• Communicate quality deficiencies to staff using the Quality Review Provide additional details about errors when necessary either to department management team or staff members.
• Identify and trend common errors and deficiencies; report them to the department's management staff to facilitate improvement within the training process.
• Work closely with department management staff to continually review processes and procedures so that the department is working efficiently and working account to full resolution.
• Assist in the department’s training process with respect to QA policy and
• Adhere to and comply with information systems security. Know and follow Information Systems security policies and procedures. Attend Information Systems security training, when offered. Report information systems security problems.
• Other duties as assigned.
• Reads and abides by the company’s code of conduct, ethics statements, employee handbook(s), policies and procedures and other corporate mandates, including participation in mandatory training programs
• Reports any real or suspected violation of the corporate compliance program, company policies and procedures, harassment or other prohibited activities in accordance with the reporting policies of the company
• Obtains clarification of policy whenever necessary and may use the resources available through the Compliance, Human Resources or Legal Department to do so
• Reviews trends for missing documentation, denials, or other RCM critical key performance indicators
• Report to management possible payor issues, system issues or staff issues
• Respond to inquiries from other departments.
• Training of new staff, QA and feedback.
• Complete QA summary file
• Support and abide by the values of the company

Benefits

• AMSURG offers a variety of health and welfare benefit options to help protect your health and promote your wellbeing. Benefits offered include but are not limited to: Paid Time Off, Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking & HSAs, and a matching 401(K) Plan.
• AMSURG offers paid time off, 9 observed holidays, and paid family leave. You accrue Paid Time Off (PTO) each pay period and depending on your position and can earn a minimum of 20 days and up to 25 days per calendar year.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 501-1,000 employees