RCM Specialist, Operational Quality

4 weeks ago

Oklahoma City, United States Help At Home Full time

Help at Home RCM Specialist, Operational Quality - Chicago, Illinois

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. 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.

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