Revenue Cycle Multi-Specialty Quality Assurance Specialist
Jorie AI • Oak Brook, Illinois, United States
Salary: $25,000 Pa
Role & seniority: Revenue Cycle Multi-Specialty Quality Assurance Specialist; mid-level.
Stack/tools: End-to-end Revenue Cycle processes; EMR systems; payer rules (Medicare/Medicaid/commercial/managed care); SOP/guidelines; QA reporting.
Top 3 responsibilities
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Conduct routine audits of end-to-end process assignments to ensure SOP adherence.
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Evaluate eligibility verification, pre-authorization, coding, charge entry, billing, claims, and denials for accuracy.
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Identify trends/root causes, collaborate on process improvements, and maintain QA reports with timely submissions.
Must-have skills
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High school diploma or equivalent; 3+ years of end-to-end revenue cycle operations experience
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Knowledge of all RCM functions and payer rules; EMR systems experience
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Excellent written/verbal communication, strong analytical thinking, attention to detail, problem-solving abilities
Nice-to-haves
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Previous QA experience in a revenue cycle setting
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Ability to manage tasks in a dynamic environment
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Documentation and practical solution recording
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Location & work type: Oak Brook, Illinois (Remote); Full-Time; remote-capable with in-office/onsite potential per policy.
Full Description
About Jorie
- Jorie AI, occupies a uniquely interconnected position at the center of the healthcare industry. An inseparable part of today's healthcare billing ecosystem, with leading edge technology that is driving transformation with AI infused Robotic Process Automation for end-to-end Revenue Cycle Management, providing practice and financial management services to the healthcare industry. Applied Intelligence, Better Insight, Accelerated Efficiencies with Jorie AI.
Our work environment
- Remote opportunities
- Growth advancement opportunities
- Flexible work environment (Work-life Balance)
- Collaborative and friendly company culture
Great Benefits
- 401(k) matching up to 4%
- Medical
- Dental
- Vision
- Long/Short Term Disability insurance
- Life insurance $25,000 Paid by employer
- PTO 2 weeks
- 10 and half Holidays
About the Role
The Revenue Cycle Multi-Specialty Quality Assurance Specialist is responsible for evaluation and ensuring accuracy, and efficiency of end-to-end revenue cycle processes, various medical specialists. This role plays a pivotal role in maintaining quality standards related to eligibility verification/ authorizations, charges, basic/minimal coding, billing, collections/reimbursement, payment posting, and patient billing. The QA Specialist works closely with the QA manager to identify areas of improvement, root cause analysis, provide recommendations and assist with streamlining of processes.
Key Responsibilities Conducts routine audits of end-to-end process assignments to ensure proper SOP/guidelines are met. Evaluates eligibility verification and pre – authorization processes. Evaluates basic coding, charge entry, billing, and claims process, in addition to denied claims to ensure accuracy. Identify trends, root causes and system issues related to denials, no response, or underpayments. Collaborate with management to develop and implement process improvement plans. Maintain QA reports and complete timely weekly/monthly submissions.
Qualifications
Required High school diploma or equivalent 3 or more years of end-to-end revenue cycle operations experience Adequate knowledge of all functions in the revenue cycle Experience with payer rules, Medicare, Medicaid, commercial and managed care Experience with EMR systems Preferred Previous QA experience in a revenue cycle setting Excellent written and verbal communication skills Ability to manage tasks in an ever-changing environment. Strong analytical and critical thinking skills Attention to detail with the ability to identify and resolve problems and document practical solutions.
Location Oak Brook, Illinois (Remote) Department Payment Center Employment Type Full-Time Minimum Experience Mid-level
