Remote RCM Quality & Audit Expert

Privia Health; Northern (KY); Hybrid; USD 65,000 - 70,000; Full time

Job summary

Privia Health seeks a detail-oriented RCM Quality & Audit Specialist to ensure accuracy, efficiency, and regulatory compliance across revenue cycle processes. You will audit claims, monitor KPIs, and drive quality improvements for onshore and offshore resources.

A strong background in medical billing, coding, accounts receivable, and a focus on QA is essential. The role emphasizes root cause analysis, SOP maintenance, and collaboration with RCM leaders to achieve performance targets.

Qualifications

• Experience in auditing/QA role or equivalent RCM job related experience.
• 2+ years experience with athenaHealth and/or athenaOne.
• Advanced working knowledge of Google Suite: Sheets, Slides and Forms.
• Advanced Excel skills for data analysis, graphs, and pivot tables.
• Strong written and verbal communication; self-editing ability.

Responsibilities

• Conduct quality reviews of revenue cycle claims and workflows against SOPs.
• Develop, collect, analyze, report and measure multiple quality improvement initiatives supporting RCM operations.
• Create and maintain quality measurements to track performance improvements.
• Identify deficiencies in processes via analysis and trends.
• Create reports and deliver assessment results to leadership.
• Research root cause analysis for process improvements and training needs.
• Collaborate with RCM Leaders to ensure goals are met.
• Serve as SME on RCM workflows and participate in audits.

Skills

Quality assurance

Auditing

RCM knowledge

Data analysis

HIPAA compliance

Written communication

Verbal communication

Team collaboration

Education

Associate degree

Bachelor's degree

Tools

athenaHealth

athenaOne

Job description

Privia Health seeks a detail-oriented RCM Quality & Audit Specialist to ensure accuracy, efficiency, and regulatory compliance across revenue cycle processes. You will audit claims, monitor KPIs, and drive quality improvements for onshore and offshore resources.

A strong background in medical billing, coding, accounts receivable, and a focus on QA is essential. The role emphasizes root cause analysis, SOP maintenance, and collaboration with RCM leaders to achieve performance targets.