Middle Revenue Cycle Quality Analyst

4 days ago

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AdventHealth

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AdventHealth is a comprehensive health care network dedicated to providing whole-person care, focusing on the physical, mental, and spiritual health of patients. With over 100,000 team members across the United States, AdventHealth operates more than 50 hospitals and 1,200 care sites, offering services that range from primary and specialty care to urgent care and rehabilitation. Their approach encourages patients to actively participate in their health management through various innovative services, including an intuitive health app that allows for appointment scheduling and access to health records.

501 - 1000 employees

Founded 1973

⚕️ Healthcare Insurance

🧘 Wellness

📋 Description

• The Process Improvement and Business Support team's Middle Revenue Cycle Quality Audit (QA) Analyst supports the operations of the Middle Quality Audit, Training, and Education team by completing both overall and account-level quality reviews of functional areas across the middle revenue cycle. • Quality audits are inclusive of assessing staff adherence to middle revenue cycle policies, procedures, and guidelines established by the respective department. • The role will conduct root cause analysis to understand key issues and operational risks to help drive targeted improvements in the middle revenue cycle to support improvement across the end-to-end Revenue Cycle functions for all AdventHealth Acute operations. • The Middle Revenue Cycle Quality Audit Analysts will be responsible for quality audits that focus on assessing medical records to verify charges are supported by documentation, identification of charging opportunities and / or inaccuracies by comparing medical record documentation to itemized bill to identify charging and billing weaknesses within the system, and review of clinical department adherence to charge reconciliation. • This role involves extensive collaboration with other Process Improvement and Business Support functional areas, including but not limited to Training and Education, Analytics, Vendor Management, Automation, and Revenue Cycle and System SMEs (Subject Matter Experts) team. • The Middle Revenue Cycle Quality Audit Analyst will adhere to AdventHealth Corporate Compliance standards, as well as rules and regulations of all applicable local, state, and federal agencies and accrediting bodies.

🎯 Requirements

• Associate's Degree in business, Accounting, Finance, Health Administration, or another related field • 1+ experience in healthcare or related field, with specific emphasis on billing, charging or coding • Understanding of middle office Revenue Cycle process, charge trigger workflows including various tools and technologies leveraged by AdventHealth • Proficient knowledge of medical terminology, including Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS) • Exceptional problem-solving skills including working knowledge of revenue cycle processes, revenue integrity processes, and the components of a patient account • Demonstrates self-starter mentality, a quick thinker who is proactive and results oriented • Understanding of HIPAA privacy rules and ability to use discretion when discussing patient related information that is confidential in nature (as needed to perform duties) • Proficient in MS Office (Word, Excel, PowerPoint, Visio, Outlook, etc.) and familiarity with database programs • Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient manner • Ability to communicate professionally and effectively in English, both verbally and in written form • Strong written and verbal communication skills • Ability to be responsive to ever-changing matrix of hospital needs and act accordingly • Ability to follow complex instructions and procedures, with close attention to detail • Knowledge of Epic and associated applications leveraged within the Revenue Cycle functions • Knowledge of Medicare, Medicaid, and other third-party payers billing and reimbursement regulations/policies • Lean Six Sigma Certification-IASSC • ECA Certified Quality Assurance Manager

🏖️ Benefits

• Benefits from Day One • Career Development • Whole Person Wellbeing Resources • Mental Health Resources and Support