Revenue Cycle QA Analyst

Job Description

Job Description

Responsibilities

Artificial Intelligence; Advanced Technology; The very best in patient care. With decades of expertise, RadNet is Leading Radiology Forward .

With dynamic cross-training and advancement opportunities in a team-focused environment, the core of RadNet’s success is its people with the commitment to a better healthcare experience.

When you join RadNet as our Revenue Cycle Quality Assurance Analyst , you will be joining a dedicated team of professionals who deliver quality, value, and access in the 21st century and align all stakeholders- patients, providers, payors, and regulators achieve the best clinical outcomes.

JOB SUMMARY

The Revenue Cycle Quality Assurance (QA) Analyst performs reviews of RCO workflows, assuring quality, accuracy, timeliness and appropriateness standards are maintained and quality standards measured and achieved.

The QA Analyst also provides review, analysis, and closure of compliance and regulatory audits, as well as, BBB / OAG patient complaints specific to RCO.

Serves as subject matter expert with regard to coding and revenue cycle systems and workflows used in the business unit and cross-functionally to ensure appropriate use and maximum efficiency.

The QA Analyst performs statistical data collecting and reporting of QA activities, including new workflows; and disseminates back to RCO operational teams.

Works with documentation analyst to create educational resource and reference materials as appropriate to support business unit as a direct outcome of quality assurance review findings.

The QA Analyst participates in additional auditing, reviews, and communications with other RadNet Partners as assigned.

You will :

• Conducts analysis of QA business unit and departmental reports and scorecards; and disseminates to RCO leadership.
• Conducts auditing, reviews, analysis, and communications with other RadNet Partners (Acquisitions, Clinical Operations, Compliance etc.) as assigned.
• Reviews, analyzes, provides reporting, and closes; all compliance, regulatory, and BBB issues / complaints specific to RCO procedures.
• Completes QA analysis of all critical claims processing, follow up and denial elements using QA audit tools to correctly identify users.

Review and respond to all quality audit inquiries which include disputed findings and implement quality assurance initiatives.

• Performs daily, weekly, monthly and routine reviews of business unit coding processes to identify errors and areas where education / system enhancements are needed.
• Responsible for auditing third party partners and vendors, analyzing outcomes, communicating results to RCO leadership and the third-party partner / vendor.

If You Are :

• Bachelor’s degree preferred - in business, healthcare, accounting or finance or equivalent of education and experience required.
• Minimum of 3 years of previous healthcare administration / revenue cycle, billing management with comprehensive knowledge of CPT, HCPC, and ICD-10 codes and medical terminology.
• Preferred candidate will have a medical coding certification or equivalent of education and experience within medical billing and coding, preferably radiology coding.
• Experience in monitoring quality with the ability to develop reporting systems required.
• Revenue cycle system proficiency.

Ideal Candidate will possess :

• Attends regular corporate meetings as requested.
• Communicates, cooperates, and consistently functions professionally and harmoniously with all levels of supervision, co-workers, patients, visitors, and vendors.
• Demonstrates initiative, personal awareness, professionalism and integrity, and exercise confidentiality in all areas of performance.
• Follows all local, state and federal laws concerning employment to include but not limited to : I-9, Harassment, EEOC, Civil rights and ADA.
• Follows OSHA regulations, RadNet and site protocols, policies and procedures.
• Follows HIPAA, compliance, privacy, safety and confidentiality standards at all times.
• but not limited to : I-9, Harassment, EEOC, Civil rights and ADA.
• Follows OSHA regulations, RadNet and site protocols, policies and procedures.
• Follows HIPAA, compliance, privacy, safety and confidentiality standards at all times.

NCEC