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Quality Assurance Specialist (Revenue Cycle Management)

Quality Assurance Specialist (Revenue Cycle Management)

Job ID 
2018-2075
Location 
US-CO-Greenwood Village
Metro Area 
Denver, CO
Function 
Revenue Cycle Management
Employment Status 
Full-Time

More information about this job

Overview

U.S. Anesthesia Partners (USAP) is the largest single-specialty anesthesia practice in the country with over 4,000 clinical providers and associates.  By joining our team you will participate in a highly collaborative and dynamic environment.  As an organization we are mission focused on delivering the highest quality in patient care and you will be directly supporting our talented clinical team.  We extend this same commitment to quality to our associates and supply tools and resources that will ensure we win in the healthcare marketplace and support of USAP.

We are proud of our inclusive people culture that supports our associates to perform at their best.  USAP is an equal opportunity employer.  Candidates with physician services or related health care experience is a plus. We offer a competitive benefits package. 

Responsibilities

POSITION SUMMARY:    The purpose of the Quality Assurance Specialist position is to help drive quality and productivity in the production of medical claims data and to assure both accuracy and timeliness in all CBO claims submissions; this is a revenue cycle process job.  The Quality Assurance Specialist will specifically focus on adherence to all USAP billing compliance policies and maintain strict oversight of governmental payer requirements.  This will be done through designed process audits, written reports and analysis of the reports as needed.  Work products and outputs will include detailed audits and reports to identify process and quality deficiencies, analysis and recommended plans of actions to improve audited processes, as well as to prescribe training needs. The Quality Assurance Specialist will assist Management in routine reviews of policies and procedures and the implementation of improvement plans as needed.  All new hires must pass a drug screening and background check before being hired. 

 

ESSENTIAL DUTIES AND RESPONSIBILITIES (include but not limited to):

  • Complete audit analysis and reports at the individual, department and division level based on defined position pathways and individual / department performance and quality metrics.
  • Identify specific individual and department training needs and opportunities for performance improvement through a defined audit analysis program and assist in ongoing process improvement opportunities through audit analysis.
  • Audit work within the Charge Entry, Payment Posting and AR teams to determine compliance with Policies and Procedures.
  • Assist in development and implementation of education programs based on identified quality or productivity issues.
  • Provide follow up review of policy changes and implementation of those changes into audit process and reporting.
  • Maintain current knowledge of Medicare, Medicaid, Work Comp guidelines and rules.
  • Assist with internal and external compliance audits, account reviews on an as-needed basis.
  • Work with the Process Improvement Specialist and Trainer to improve quality and performance through process improvement initiatives.
  • Maintain strictest confidentiality.
  • Performs other duties, as assigned

Qualifications

  • High School diploma or equivalent.  
  • Associate’s or Bachelor’s degree in a business or health related field is preferred.
  • Must have minimum of 2 years billing or collections experience in the health care field.

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