REV CYCLE QA SPECIALIST

City/State

Norfolk, VA

Overview

Work Shift

First (Days) (United States of America)

Sentara Health is seeking to hire a qualified individual to join our team as a Revenue Cycle QA Specialist

Position Status: Full-time, Day Shift

Position Location: This is a Hybrid position for residents of VA or North Carolina (traveling flexibility is required).

Position Summary: 

Responsible for performing quality assurance reviews for assigned areas of the Revenue Cycle and Patient Access. Focus on improving the accuracy and productivity of all revenue cycle systems by assisting in facilitating, completing operations improvement projects, monitoring and improving quality of the patient account integrity.

Under the direction of the Revenue Cycle Education Leadership team, Revenue Cycle Quality Assurance Specialist will assist in data collection, data analysis, reporting, coordination of projects, assist in implementing processes, and communication of efforts.

Duties may include, but are not limited to, reviews of insurance and denials management processes, claim and account detail, assuring quality, accuracy, timeliness and appropriateness standards are maintained and quality standards measured and achieved. Serves as subject matter expert with regard to assigned revenue cycle systems and business processes used to ensure appropriate use and maximum efficiency. Performs process, operational and system workflow monitoring/reviews to ensure that efficient, cost effective work processes are being executed and/or creates tracking of areas that need to be addressed by management to optimize workflow, quality and performance.

Standard Working Hours: 8:00AM to 5:00PM (ET).

Minimum Requirements:

• Minimum of 2 years Registration, Billing or Collections experience required.

• Bachelor's Degree preferred.

• Hospital Billing experience, denials and follow-up

• Commercial Payers experience

• Knowledge of Revenue Cycle software systems required (HBOC, MCKESSON, EPIC PRELUDE/RESOLUTE). Must be proficient with EPIC - Grand Central/Prelude/Resolute and trained as a super user for HBOC.

   Sentara Overview

For more than a decade, Modern Healthcare magazine has ranked Sentara Health as one of the nation's top integrated healthcare systems.  That's because we are dedicated to growth, innovation, and patient safety at more than 300 sites of care in Virginia and northeastern North Carolina, including 12 acute care hospitals.
Sentara Benefits
As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America's best large employers.  We offer a variety of amenities to our employees, including, but not limited to: 

 Medical, Dental, and Vision Insurance

• Paid Annual Leave, Sick Leave
• Flexible Spending Accounts
• Retirement funds with matching contribution
• Supplemental insurance policies, including legal, Life Insurance and AD&D among others
• Work Perks program including discounted movie and theme park tickets among other great deals
• Opportunities for further advancement within our organization

Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace.  For information about our employee benefits, please visit: Benefits - Sentara (sentaracareers.com)
Please Note: The yearly Flu Vaccination is required for employment.

Note: Sentara Health offers employees comprehensive health care and retirement benefits designed with you and your family's well-being in mind. Our benefits packages are designed to change with you by meeting your needs now and anticipating what comes next. You have a variety of options for medical, dental and vision insurance, life insurance, disability, and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave. Team Members have the opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met.

Job Summary

Responsible for performing quality assurance reviews for assigned areas of the Revenue Cycle and Patient Access, with a focus on improving the accuracy and productivity of all revenue cycle systems by assisting in facilitating, completing operations improvement projects, monitoring and improving quality of the patient account integrity. Under the direction of the Revenue Cycle Education Leadership team, Revenue Cycle Quality Assurance Specialist will assist in data collection, data analysis, reporting, coordination of projects, assist in implementing processes, and communication of efforts. Duties may include, but are not limited to, reviews of insurance and denials management processes, claim and account detail, assuring quality, accuracy, timeliness and appropriateness standards are maintained and quality standards measured and achieved. Serves as subject matter expert with regard to assigned revenue cycle systems and business processes used to ensure appropriate use and maximum efficiency. Performs process, operational and system workflow monitoring/reviews to ensure that efficient, cost effective work processes are being executed and/or creates tracking of areas that need to be addressed by management to optimize workflow, quality and performance.
2 years Registration, Billing or Collections experience required. Bachelor's Degree preferred. Knowledge of Revenue Cycle software systems required (HBOC, MCKESSON, EPIC PRELUDE/RESOLUTE). Must be proficient with EPIC - Grand Central/Prelude/Resolute and trained as a super user for HBOC.

Qualifications:

BLD - Bachelor's Level DegreeHealthcare, Leadership, Quality Improvement, Registration/Billing

Skills

Accounting/Auditing, Communication, Critical Thinking, Microsoft Office, Project Management, Reading Comprehension, Service Orientation, Social Perceptiveness, Speaking, Technology/Computer, Time Management, Writing

Sentara Healthcare prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.

Per Clinical Laboratory Improvement Amendments (CLIA), some clinical environments require proof of education; these regulations are posted at ecfr.gov for further information. In an effort to expedite this verification requirement, we encourage you to upload your diploma or transcript at time of application.

In support of our mission “to improve health every day,” this is a tobacco-free environment.