Revenue Cycle QA Auditor

QHR Health, LLC dba Ovation Healthcare; United States; Remote; USD 61,000 - 92,000; Full time

Benefits offered by this job

Health benefits

HSA with employer contributions

Flexible spending accounts

Wellness platform with premium incent­

Paid time off

401(k) plan with employer match

Professional development

Equipment provided

Job summary

Ovation Healthcare seeks a Revenue Cycle QA Auditor to support quality audits of hospital billing. You will evaluate performance, generate reports, and collaborate with Education and Quality leadership to drive improvements across the Revenue Cycle.

With 5+ years in hospital billing, you will leverage expertise in Medicare/Medicaid and various billing platforms to ensure audits are thorough, objective, and timely, while fostering staff development and process standardization.

Qualifications

• Minimum five years in hospital business office billing and collections.
• Expert level billing and/or collections with Medicare, Medicaid, commercial and/or self-pay.
• Medical billing software expertise in Meditech, CPSI, Medhost, EPIC and related systems.

Responsibilities

• Provide quality audit services to evaluate and improve Revenue Cycle performance.
• Ensure audits are completed accurately, objectively, and timely.
• Complete documentation to support audit work.
• Create performance reports for staff, department, and leadership.
• Identify and report on quality trends and support training.
• Recommend action plans with trainers and managers.
• Process audit disputes with timely feedback to management.
• Manage internal customer relationships and close issues.
• Complete other duties by Education and Quality Director.
• Coordinate audit schedules to ensure compliance with procedures.
• Prepare all documentation for reporting.
• Design and produce quality scorecards as required.
• Contribute to department policy and procedure input.

Skills

A/R management

Medicare/Medicaid billing

Billing software

Communication skills

Leadership & planning

Critical thinking

Education

High School Diploma or GED

College degree preferred

Tools

Meditech

CPSI

Medhost

EPIC

Rycan

Emdeon

Relays Health

Trubridge

Athena

Job description

About the Job

Welcome to Ovation Healthcare! At Ovation Healthcare (formerly QHR Health), we've been making local healthcare better for more than 40 years. Our mission is to strengthen independent community healthcare. We provide independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong sense of purpose and commitment to operating excellence, we help rural healthcare providers fulfill their missions. The Ovation Healthcare difference is the extraordinary combination of operations experience and consulting guidance that fulfills our mission of creating a sustainable future for healthcare organizations. Ovation Healthcare's vision is to be a dynamic, integrated professional services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer focused behavior. We're looking for talented, motivated professionals with a desire to help independent hospitals thrive. Working with Ovation Healthcare, you will have the opportunity to collaborate with highly skilled subject matter specialists and operations executives, in a collegial atmosphere of professionalism and teamwork. Ovation Healthcare's corporate headquarters is located in Brentwood, TN. For more information, visit www.ovationhc.com.

Summary

The Revenue Cycle QA Auditor, reflects the mission, vision, and values of Resolution RCM, adheres to the organization's Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards.

Responsibilities

• Responsible for providing quality audit services to evaluate and improve Revenue Cycle performance.
• Ensures that all quality audits are completed accurately, objectively, and in a timely manner.
• Completes all necessary documentation to support audit work.
• Creates performance reports for staff, department, and leadership as required.
• Identifies and produces reports for overall quality trends and provides input to Education and Quality Director, for training and development.
• Makes recommendations for the development of action plans with trainers, Managers, and/or Team Leads.
• Processes audit disputes, providing thorough and timely feedback to management and Education and Quality Director.
• Manages internal customer relationships and follows issues through to closure.
• Completes other duties assigned by Education and Quality Director.
• Additional Functions Coordinates audit schedule to ensure compliance with quality audit procedures for staff and departments.
• Completes all supporting information and documentation required for individual and departmental reporting.
• Designs and produces reports and individual quality scorecards as required.
• Provides input to Education and Quality Director for department policies and procedures.
• Consistently communicates quality audit results to appropriate Manager, Team Lead and/or Staff.
• Ensure compliance with quality sign off and documentation procedures for Quality Auditors, Department Manager, and Team Lead.
• Assesses and communicates staff development needs to Education and Quality Director and training team.
• Assists with development of training material based on trends identified in monthly audits.
• On occasion may assist with the training of staff based on trends identified.

Required Skills and Experience

• Minimum five (5) years of general hospital business office billing and collections experience
• Understands A/R management concepts for CAH/general hospital, and business office operations
• Expert level billing and/or collections with Medicare, Medicaid, commercial and/or self-pay
• Medical billing software expertise in (but not limited to): Meditech (MAGIC, Client Server or Expanse), CPSI, Medhost, EPIC, Meditech, Rycan, Emdeon, Change, Relay Health, Trubridge, Athena, etc.
• Excellent written and verbal skills and demonstrates the ability to manage workload and prioritize while multi-tasking in a fast-paced environment
• Must possess excellent people skills
• Critical thinking skills
• Strong computer skills (Word, Excel, PowerPoint)
• Strong leadership, organization, planning and time management skills
• Strong ability to grasp new concepts and apply them
• Strong ability to understand complex workflows and follow procedures
• Education: High School Diploma or GED required, college degree or some college preferred
• Additional certification/training via CMS MedLearn, HFMA, AHAM, AMA preferred

Benefits

The base compensation range for this position is: $61,111.77 - $91,667.65 Compensation ranges could be hourly or salary depending upon the exempt status of the posted position. Beginning compensation is determined based on objective factors such as location, qualifications, skills, certifications, and experience. Typically, a candidate is hired in the lower to midpoint of the range; the top end of the range is reserved for candidates with extensive specialized experience and mastery within the role. Compensation may increase over time based on performance, experience, and tenure. Compensation is only part of Ovation's total compensation package.

• Comprehensive health and wellness benefits such as medical, dental, vision, life insurance, short and long-term disability coverage
• HSA with employer contributions, flexible spending accounts for health care, and dependent care accounts
• Wellness platform with premium incentives Employee assistance support and additional voluntary supplemental plans including accident, critical illness, hospital indemnity, and child disability insurance
• Robust and flexible paid time off offerings and company paid holidays
• 401(k) plan with discretionary employer match opportunities
• Professional development opportunities
• Company issued equipment

Headquartered in Brentwood, Tenn., Ovation Healthcare partners with 375+ hospitals and health systems across 47 states. For 45+ years, Ovation Healthcare has supported hospitals and health systems through a portfolio of shared services - Leadership Advisory, Spend Management, Revenue Cycle Management, and Technology Services - designed to provide scale and efficiency to hospital business operations.