Revenue Cycle Multi-Specialty Quality Assurance Specialist

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.