RCM Quality Assurance

2 days ago


San Diego, United States Remitz, Inc Full time

Remitz is a forward-thinking company at the forefront of revolutionizing the $250B Revenue Cycle Management Industry. Specializing in medical billing software, we deploy breakthrough AI and cutting-edge technology to modernize the world of medical insurance claims. Our innovative solutions are meticulously designed to enhance efficiency, accuracy, and compliance in medical billing. This approach ensures smoother financial operations for healthcare providers, enabling hospitals, doctors, and medical professionals to reclaim their share of the $5 trillion in revenue they have rightfully earned. Join our team of passionate professionals dedicated to leveraging technology for a significant impact in the healthcare industry. Position Summary: The RCM Quality Assurance Analyst plays a pivotal role in our operations, focusing on the accuracy and compliance of reworked claims and appeals. This role involves rigorous auditing of billing and coding practices, providing constructive feedback to improve appeal success rates, and maintaining exceptional quality standards throughout the appeals process. The ideal candidate will have a keen eye for detail and a thorough understanding of U.S. healthcare laws and regulations, ensuring all operations are compliant and of the highest quality. Key Responsibilities: Conduct detailed audits of billing and coding practices for appealed claims. Provide targeted feedback to enhance the quality and success rate of appeals. Uphold and promote exceptional quality standards throughout the appeals process. Ensure strict compliance with U.S. healthcare laws and regulations in all operations. Collaborate with team members to identify and implement quality improvement initiatives. Qualifications: Proven experience in RCM, quality assurance, or a similar role within the healthcare sector. Strong knowledge of billing and coding practices, especially in relation to appealed claims. Familiarity with U.S. healthcare regulations, including HIPAA. Excellent analytical and problem-solving skills, with a keen eye for detail. Exceptional communication skills, capable of providing constructive feedback. A commitment to promoting high standards of accuracy and compliance. #J-18808-Ljbffr


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