Sr. Quality Assurance Specialist

3200 North Shore Medical Center, Inc.; Salem (VA); Hybrid; USD 64,000 - 93,000; Full time

Job summary

North Shore Medical Center, Inc. is seeking a Patient Access Services (PAS) Billing QA specialist to ensure quality and accuracy of registrations, billing, and claims processing.

You will perform QA reviews, analyze workflows, and collaborate to improve patient access operations using Epic. This role oversees training and QA programs, develops materials, tracks regulatory compliance, and supports staffing and timekeeping.

Qualifications

• Experience in PAS billing, billing or QA in healthcare.
• Proficient in Epic and billing workflows.
• Strong analytical skills and ability to train staff effectively.

Responsibilities

• Designs and evaluates employee training programs to enhance accuracy, efficiency, and compliance.
• Conducts quality assurance reviews and audits to ensure compliance and identify improvement opportunities.
• Analyzes performance metrics and trends, providing actionable insights and reports to management.
• Maintains documentation of QA practices, procedures, and audit outcomes.
• Ensures regulatory compliance with federal, state, and organizational policies.
• Manages staffing logistics, including shift coverage and monthly scheduling.
• Supports timekeeping and approvals in UKG as a designated delegate.
• Provides cross-functional and real-time operational support across Patient Access areas, including ED Registration.
• Work alongside manager to ensure appropriate staffing and efficient workflows in patient areas.

Skills

PAS billing

Claims processing

Quality assurance

Analytical skills

Billing software

Data analysis

Training staff

Effective communication

Education

Associate degree: Healthcare Administration

Associate degree: Business

Associate degree: Related Field

Tools

Epic

Job description

Site: North Shore Medical Center, Inc. Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Responsible for ensuring the quality and accuracy of Patient Access Services (PAS) billing and claims processes. Performs quality assurance reviews, analyzes workflows, and collaborates with staff to ensure compliance with billing policies and improve patient access operations. This role will provide oversight of the patient access service training and quality assurance processes to ensure materials are compliant and current with Epic and industry standards.

Key areas of focus will include ensuring the quality of registrations across the hospital is meeting benchmarks to eliminate added volume in work queues and ensure efficient claim processing. Actively work in Epic software to review registration errors, authorizations and insurance claim edits. Identifies areas for improvement and develops, implements, maintains, and continuously evaluates the training program for patient access employees. This role will also serve as a subject matter expert and assist with Epic system upgrades and education and re‑training of staff. Does this position require Patient Care? No

Essential Functions

• Designs and evaluates employee training programs to enhance accuracy, efficiency, and compliance.
• Conducts quality assurance reviews and audits to ensure compliance and identify improvement opportunities.
• Analyzes performance metrics and trends, providing actionable insights and reports to management.
• Maintains documentation of QA practices, procedures, and audit outcomes.
• Ensures regulatory compliance with federal, state, and organizational policies.
• Manages staffing logistics, including shift coverage and monthly scheduling.
• Supports timekeeping and approvals in UKG as a designated delegate.
• Provides cross-functional and real-time operational support across Patient Access areas, including ED Registration.
• Work alongside manager to ensure appropriate staffing and efficient workflows in patient areas.

Qualifications Education

Associate's Degree Healthcare Administration required or Associate's Degree Business required or Associate's Degree Related Field of Study required

Can this role accept experience in lieu of a degree? Yes

Licenses and Credentials

Experience Experience in PAS, billing, or quality assurance 2-3 years required and Experience within a healthcare environment 2-3 years preferred

Knowledge, Skills and Abilities

• In-depth understanding of PAS billing, claims processing, and quality assurance practices.
• Strong analytical skills, with the ability to identify trends and provide actionable insights.
• Proficiency in using billing software and data analysis tools.
• Effective communication skills, with the ability to train and collaborate with team members.
• Detail-oriented with a strong focus on accuracy and compliance.

Additional Job Details (if applicable)

Physical Requirements Standing Occasionally (3-33%) Walking Occasionally (3-33%) Sitting Constantly (67-100%) Lifting Occasional (3-33%) 20lbs - 35lbs Carrying Occasional (3-33%) 20lbs - 35lbs Pushing Rarely (Less than 2%) Pulling Rarely (Less than 2%) Climbing Rarely (Less than 2%) Balancing Occasionally (3-33%) Stooping Occasionally (3-33%) Kneeling Rarely (Less than 2%) Crouching Rarely (Less than 2%) Crawling Rarely (Less than 2%) Reaching Occasionally (3-33%) Gross Manipulation (Handling) Constantly (67-100%) Fine Manipulation (Fingering) Frequently (34-66%) Feeling Constantly (67-100%) Foot Use Rarely (Less than 2%) Vision - Far Constantly (67-100%) Vision - Near Constantly (67-100%) Talking Constantly (67-100%) Hearing Constantly (67-100%)

Remote Type Hybrid Work Location 81 Highland Avenue

Scheduled Weekly Hours 40

Employee Type Regular Work Shift Day (United States of America)

Pay Range $63,648.00 - $92,570.40/Annual Grade 6

EEO Statement

3200 North Shore Medical Center, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at (857)-282-7642.

Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.

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