Quality Assurance Specialist - Patient Access-30975

Rush University Medical Center; Chicago (IL); Hybrid; USD 35,000 - 55,000; Full time

Job summary

Rush University Medical Center is seeking a QA Specialist for the Patient Access-Pre-Visit team in Chicago. The role performs quality monitoring to ensure adherence to workflows, policies, and regulatory requirements, supporting both onsite and remote staff.

You will work closely with Patient Access leadership to improve processes and patient experience. The position requires strong communication, data analysis, and problem-solving skills, with experience in healthcare settings and proficiency

Qualifications

• High school diploma or equivalent is required.
• 1-2 years of experience in a hospital or clinical setting preferred.
• Must have basic Microsoft Office skills (Word, PowerPoint, Excel).
• Excellent communication and customer service skills are essential.
• Basic keyboarding skills and ability to analyze data required.
• Strong problem solving, critical thinking and attention to detail needed.
• Able to work in a fast-paced, multi-tasking environment and maintain confidentiality.

Responsibilities

• Monitor and track performance at team and individual levels with trend data for management review.
• Prepare and analyze internal and external quality reports (e.g., DNFB, claim edits, aged accounts).
• Review prior account notes and document interactions; follow up for updates to resolutions.
• Maintain HIPAA confidentiality and adhere to organizational policies and procedures.
• Attend Epic or related training to support Financial Counseling functions.
• Collaborate with multiple departments to resolve issues affecting hospital reimbursement.

Skills

Strong communication skills

Excellent customer service

Data analysis

Critical thinking

Time management

Attention to detail

Confidentiality

Multi-tasking

Problem solving

Team oriented

Education

High school diploma or equivalent

Associates Degree in Accounting or Business Administration

Working knowledge of medical terminology and anatomy/physiology

Tools

Microsoft Word

Excel

PowerPoint

EPIC training

Job description

Location: Chicago, Illinois

Business Unit: Rush Medical Center

Hospital: Rush University Medical Center

Department: Patient Access-Pre-Visit

Work Type: Full Time (Total FTE between 0.9 and 1.0)

Shift: Shift 1

Work Schedule: 8 Hr (8:00:00 AM - 4:30:00 PM)

Rush offers exceptional rewards and benefits learn more at our Rush benefits page (https://www.rush.edu/rush-careers/employee-benefits).

Pay Range: $25.20 - $39.69 per hour

Rush salaries are determined by many factors including, but not limited to, education, job-related experience and skills, as well as internal equity and industry specific market data. The pay range for each role reflects Rush’s anticipated wage or salary reasonably expected to be offered for the position. Offers may vary depending on the circumstances of each case.

Summary

The Quality Assurance (QA) Specialist is responsible for performing quality monitoring to ensure Patient Access staff are adhering to expected workflows, internal policies, registration across the organization and external regulatory requirements. The QA Specialist is an on-campus position supporting across departmental processes. This position will work closely with Patient Access leadership. This position will provide support for both onsite and remote staff. Exemplifies the Rush mission, vision and values and acts in accordance with Rush policies and procedures.

Required Job Qualifications

• High school graduate or equivalent
• 1-2 years of experience
• Experience within a hospital or clinic environment, a health insurance company, managed care organization or other health care financial service setting
• Must have a basic understanding of the core Microsoft suite offerings (Word, PowerPoint, Excel).
• Excellent communication and outstanding customer service and listing skills.
• Basic keyboarding skills
• Ability to analyze and interpret data
• Critical thinking, sound judgment and strong problem-solving skills essential
• Team oriented, open minded, flexible, and willing to learn
• Strong attention to detail and accuracy required
• Ability to prioritize and function effectively, efficiently, and accurately in a multi-tasking complex, fast paced and challenging department.
• Ability to follow oral and written instructions and established procedures
• Ability to function independently and manage own time and work tasks
• Ability to maintain accuracy and consistency
• Ability to maintain confidentiality

Preferred Job Qualifications

• Associates Degree in Accounting or Business Administration
• Working knowledge of medical terminology and anatomy and physiology is preferable.

Competencies

Physical Demands

Disclaimer: The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.

Responsibilities

Provides on-going monitoring to compile and track performance at the team and individual level and provides trend data to the management team. Prepares and analyzes internal and external quality reports for management staff to review – High dollar accounts; Aged accounts; Guarantor change account; CEA report; Claim edits; DNB accounts. Works newborn accounts – monitoring the addition of insurance for newborn coverage.

• Reviews prior account notes for past due balances and any information that might aid in the account resolution process, as well as documents all encounters and actions. Follows up with responsible person managing account for updates to resolution.
• Monitors daily Metrics dashboard for additional accounts that will impact overall increase in unresolved accounts that would impact department’s dashboard metrics for DNFB, Claim edits, and CFB Days.
• Exercise exceptional customer service skills when communicating with our team members, as well as our internal customers. Finds resolution within the phone interaction satisfactory to the caller and/or having the knowledge when to escape to their supervisor.
• Interacts and collaborates with numerous departments to resolve issues while also analyzing necessary information that will ensure hospital reimbursement. Initiates requests for financial Rush University Medical Center’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures to ensure adherence in a manner that reflects honest, ethical, and professional behavior. Guards to assure that HIPAA confidential medical information is protected.
• Attends regular EPIC training sessions or other sessions conducted for the benefit of associates involved in the Financial Counseling functions at all levels.
• Other duties as needed and assigned by the supervisor/manager.

Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.