Revenue Cycle QA & Compliance Specialist

VETERANS VILLAGE OF SAN DIEGO, INC; San Diego (CA); On-site; USD 65,000 - 95,000; Full time

Job summary

Veterans Village of San Diego, Inc. is seeking a Revenue Cycle & Quality Assurance Specialist to oversee billing operations, documentation quality, compliance, and provider enrollment across three outpatient mental health clinics.

The role focuses on accuracy and integrity of clinical documentation and billing, while supporting quality improvement initiatives and regulatory requirements.

Qualifications

• Associate’s or Bachelor’s degree in healthcare administration, business, public health, accounting, or related field or 5 years of experience.
• Minimum 3 years in healthcare billing, revenue cycle, quality assurance, compliance, or healthcare operations.
• Experience with outpatient behavioral health or medical practices preferred.
• Strong knowledge of commercial insurance, Medicare, and managed care billing practices.
• Proficiency with Excel, pivot tables, formulas, and reporting.
• Experience with EHR and practice management systems.

Responsibilities

• Oversee billing operations, review claims and documentation for accuracy and compliance.
• Resolve denials and discrepancies; reconcile billing with EHR records.
• Conduct chart audits to ensure services billed are supported by records.
• Identify deficiencies and recommend corrective actions and training.
• Monitor regulatory compliance and support audits and accreditation.
• Maintain QA tracking systems and prepare performance reports.
• Collaborate with clinic leadership to improve revenue cycle performance.
• Provide training on documentation standards, billing, and compliance.
• Manage provider credentialing and payer enrollment activities.

Skills

Excel

EHR systems

Practice management

Revenue cycle

Documentation standards

Analytical skills

Communication

Education

Bachelor’s or Associate degree in Healthcare Administration or related field

5 years of healthcare billing/revenue cycle experience

Tools

CAQH

EHR software

Job description

Veterans Village of San Diego, Inc. is seeking a Revenue Cycle & Quality Assurance Specialist to oversee billing operations, documentation quality, compliance, and provider enrollment across three outpatient mental health clinics.

The role focuses on accuracy and integrity of clinical documentation and billing, while supporting quality improvement initiatives and regulatory requirements.