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RCM Specialist, Operational Quality

3 months ago


Chicago, Illinois, United States Help At Home Full time

Help at Home is the leading national provider of in-home personal care services, where our mission is to enable individuals to live with independence and dignity at home. Our team supports 66,000 clients monthly with the help of 49,000 compassionate caregivers across 12 states. We're focused on serving people and the communities we are part of.

Job Summary:

The RCM Specialist (Operational Quality) reports to the RCM Manager, Operational Quality. This position assists in enforcing controls around auditing, quality assurance, reporting and other aspects of RCM. Primary responsibilities include assisting in audit request retrieval related to the revenue cycle and performing quality control validations around RCM policy and procedures. Require a high degree of attention to detail, and the ability to analyze and communicate issues.

This is a REMOTE role.

As a key member of the team:

  • You are flexible and can embrace change
  • You value progress over perfection
  • You care about your work, the team you're on, and the people we are helping
  • You make it a priority to get to know the people around you – build relationships with your colleagues and business partners
  • You say what needs to be said, while considering how it'll affect culture and output
  • Hold others to a high standard

Essential Duties and Responsibilities:

  • Provide information to auditors per request such as invoices, eligibility documentation, authorizations, remittance, and audit logs.
  • Deep understanding of Client Access (authorization, eligibility), AR receivables and cash application to be able to fully scope accurate QA policies and scorecards and assist in QA review of RCM policies and procedures as designated by leadership.
  • Work closely with Manager, Operational Quality to develop workflows, control gaps, and remediation plans for all RCM markets.
  • Participate in documentation of QA review with outcomes and feedback provided monthly to RCM leadership team.
  • Produce reports as needed.
  • Perform other duties as assigned.

Required Skills/Abilities:

  • Self-motivated; reliable; strong attention to detail; maintains confidentiality; complies with all Company policies and procedures.
  • Demonstrates excellent communication skills under duress at a fast pace; ability to function as a positive team member
  • Intermediate to advanced computer skills, including the use of Microsoft Office applications.

Education and Experience:

  • High School diploma or GED required.
  • One (1) to two (2) years' experience of revenue cycle management or billing experience in the healthcare field