Revenue Cycle Quality Auditor Hospital Side - Insurance Coding Verification

Quality Assurance Specialist

Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

Responsibilities

Responsible for performing & maintaining the quality assurance processes for all registration, admissions and PBX personnel across the organization.

Performs audits to ensure quality and compliance standards are met.

Processes error disputes within quality assurance system, providing timely feedback to staff.

Performs account review for account financial resolution opportunities and performance opportunities.

Observes areas for operational flow opportunities.

Reviews patient satisfaction data and detail patient comments for feedback and QA application.

Performs compliance process audits, such as Important Message from Medicare, Medicaid plan application, Medicare Secondary Payer Questionnaire, Annual required signatures on file, etc.

Audits HPF and HBF queues, as appropriate.

Performs audits of other nature, as assigned.

Reassigns scanned images, as needed.

Attends training team meetings.

Evaluates/Completes weekly quality report. Analyzes trends in data, makes recommendations for training needs.

Performs duties of Patient Access Representative, Room Control Representative and PBX Operator.

Qualifications

REQUIRED:

1. High School Diploma and/or equivalent

2. THREE YEARS' REGISTRATION EXPERIENCE

3. Functional knowledge of ADT and related systems

4. Excellent written and oral communication skills

5. Strong analytical, problem solving, trouble shooting skills

6. Skilled in the use and application of Microsoft Office Suite (Power Point, Word, Excel, Access, Outlook)

PREFERRED: 1. Bachelor's degree in Healthcare Management or related field

2. Knowledge of Federal and State regulations

3. Knowledge of JCAHO requirements

4. Demonstrated knowledge of insurance verification, precert, billing and collection procedures

5. CHAA (Certified Healthcare Access Associate) or CPAR (Certified Patient Account Representative)

Work Hours:

Tues-Sat 7a-345p (45 minute lunch)

Weekend Requirements:

Yes

On-Call Requirements:

No