Revenue Cycle Management Quality Expert
1 week ago
We are seeking a detail-oriented and analytical Revenue Cycle Management Quality Analyst to oversee the evaluation and improvement of revenue cycle processes at 2coms. The ideal candidate will have a keen eye for detail, strong analytical skills, and a deep understanding of healthcare revenue cycle management.
Key Responsibilities:
- Quality Monitoring: Assess the accuracy and quality of revenue cycle processes, including eligibility verification, billing, coding, claims submission, and payment posting.
- Quality and Process Auditing: Conduct regular audits of RCM production and processes to identify discrepancies, errors, and areas for improvement.
- Data Analysis: Analyze data to identify trends, root causes of errors, and opportunities for process optimization.
- Compliance: Ensure all RCM activities comply with relevant regulations, including HIPAA, ICD-10, and payer-specific guidelines.
- Reporting: Prepare detailed reports on audit findings, quality metrics, and improvement recommendations for management.
- Feedback & Training: Provide constructive feedback to the RCM teams and assist in training initiatives to enhance accuracy and efficiency.
- Continuous Improvement: Collaborate with the RCM team to implement process improvements and standardization efforts.
- Documentation: Maintain accurate and up-to-date documentation of quality assurance activities and audit results.
Requirements:
- Education: Bachelor's degree in healthcare administration, finance, business, or a related field.
- Experience: Minimum of 2-4 years of experience in revenue cycle management, with a focus on quality assurance or auditing.
- Technical Skills: Proficiency in RCM software, electronic health records (EHR), and medical billing systems.
- Knowledge: In-depth understanding of healthcare billing, coding, and reimbursement processes, including knowledge of ICD-10, CPT, and HCPCS codes.
- Analytical Skills: Strong ability to analyze data, identify trends, and provide actionable insights.
- Attention to Detail: Exceptional attention to detail, with a focus on accuracy and compliance.
- Communication Skills: Excellent verbal and written communication skills, with the ability to present findings clearly and effectively.
- Problem-Solving: Ability to identify issues and propose effective solutions to enhance process quality.
- Team Collaboration: Experience working in a team-oriented environment, with a collaborative approach to problem-solving.
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