QA Engineer

• The Revenue Cycle Multi-Specialty Quality Assurance Specialist is responsible for evaluation and ensuring accuracy, and efficiency of end-to-end revenue cycle processes across various medical specialties
• Maintains quality standards related to eligibility verification/authorizations, charges, basic/minimal coding, billing, collections/reimbursement, payment posting, and patient billing
• Works with QA manager to identify improvement areas, perform root cause analysis, provide recommendations and assist with streamlining processes
• 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 processes, in addition to denied claims to ensure accuracy
• Identifies trends, root causes and system issues related to denials, no response, or underpayments
• Collaborates with management to develop and implement process improvement plans
• Maintains QA reports and completes timely weekly/monthly submissions

Quality Assurance Specialist, Revenue Cycle – Multi-Specialty

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