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: EMR systems; knowledge of payer rules (Medicare, Medicaid, commercial, managed care); end-to-end Revenue Cycle processes; billing/claims/denials; QA reporting
Top 3 responsibilities
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Conduct routine audits of end-to-end process assignments to ensure SOPs/guidelines are met
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Evaluate eligibility verification, pre-authorization, coding, charge entry, billing, and claims, including denied claims
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Identify trends/root causes of denials or underpayments; collaborate on process improvements; maintain QA reports and timely submissions
Must-have skills
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High school diploma or equivalent; 3+ years of end-to-end revenue cycle operations
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Broad knowledge of revenue cycle functions and payer rules; EMR experience
Nice-to-haves
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Prior QA experience in a revenue cycle setting
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Strong written/verbal communication; ability to manage in changing environments; analytical, detail-oriented; problem-solving documentation
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Location & work type: Remote opportunities; flexible work environment with growth opportunities and benefits (401(k) matching, medical/dental/vision, disability, life insurance, PTO, holidays)
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.
