RCM Quality Assurance Specialist

Title: RCM Quality Assurance Specialist

Location: United States

Job Category: Corporate
Requisition Number: RCMQU008964
Full-Time
Remote

Job Description:

RCM QUALITY ASSURANCE SPECIALIST

REMOTE

Company Overview: AMSURG is an independent leader in ambulatory surgery center services, operating a network of more than 250 surgery centers nationwide. In partnership with physicians and health systems, the organization delivers high-quality care for patients across a diverse spectrum of medical specialties, including gastroenterology, ophthalmology and orthopedics. 

Position Summary: The Quality Assurance Specialist in the RCM department will review the quality of records, provide reconciliation analysis utilizing internally developed norms and criteria. The Quality Assurance Specialist will also have specialized QA functions as described below.

Essential Duties and Responsibilities

• Daily auditing of RCM account worked by staff to ensure accuracy based on QA policies and procedures.
• Gather of general documentation issues for the purpose of educational feedback.
• Document and maintain QA findings on appropriate Complete monthly summary reports based on daily findings and distribute them to appropriate management personnel.
• Communicate quality deficiencies to staff using the Quality Review Provide additional details about errors when necessary either to department management team or staff members.
• Identify and trend common errors and deficiencies; report them to the departments management staff to facilitate improvement within the training process.
• Work closely with department management staff to continually review processes and procedures so that the department is working efficiently and working account to full resolution.
• Assist in the department's training process with respect to QA policy and
• Adhere to and comply with information systems security. Know and follow Information Systems security policies and procedures. Attend Information Systems security training, when offered. Report information systems security problems.
• Other duties as assigned.
• Reads and abides by the company's code of conduct, ethics statements, employee handbook(s), policies and procedures and other corporate mandates, including participation in mandatory training programs
• Reports any real or suspected violation of the corporate compliance program, company policies and procedures, harassment or other prohibited activities in accordance with the reporting policies of the company
• Obtains clarification of policy whenever necessary and may use the resources available through the Compliance, Human Resources or Legal Department to do so
• Reviews trends for missing documentation, denials, or other RCM critical key performance indicators
• Report to management possible payor issues, system issues or staff issues
• Respond to inquiries from other departments.
• Training of new staff, QA and feedback.
• Complete QA summary file
• Support and abide by the values of the company

Position Qualifications:

• High School diploma or general education degree (GED) required.
• Associate degree in RHIT preferred
• Five (5) + years related RCM QA audit experience and/or training; or equivalent combination of education and experience preferred.
• Working knowledge of RCM billing system.
• Good computer skills including the ability to be on multiple screens at once as well as use the zoom in and zoom out feature.

Employment at AMSURG: Living Our Values Every Day

At AMSURG, our values define who we are and how we serve our patients, partners, and each other. As a national leader in ambulatory surgery, we are committed to a culture of excellence, integrity, teamwork and caring deeply. Our values guide every decision, ensuring we continue to elevate healthcare and provide the highest quality care.

These guiding principles are the foundation of our culture and a guide to how we collaborate, innovate, and make a difference every day.

Care Deeply for those around us.

Cultivate Integrity to build trust.

Champion Excellence for continuous improvement.

Celebrate Teamwork every step to the way.

Benefits: To ensure we retain and invest in great people, AMSURG provides its employees with the benefits, recognition, training, and opportunities needed for professional growth. Our wide range of health and welfare benefits allow you to choose the right coverage for you and your family. AMSURG offers a variety of health and welfare benefit options to help protect your health and promote your wellbeing. Benefits offered include but are not limited to: Paid Time Off, Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, Limited Healthcare FSA, FSAs for Transportation and Parking & HSAs, and a matching 401(K) Plan.

Paid Time Off: AMSURG offers paid time off, 9 observed holidays, and paid family leave. You accrue Paid Time Off (PTO) each pay period and depending on your position and can earn a minimum of 20 days and up to 25 days per calendar year.

EOE Statement: AMSURG is an Equal Opportunity Employer (EOE). Qualified applicants are considered for employment without regard to age (40 or older), race, color, religion, gender, sex, national origin, pregnancy, sexual orientation, disability, genetic information or any other status protected under applicable federal, state, or local laws. We strive to also provide a disability inclusive application and interview process.