Revenue Cycle Quality Assurance Specialist - Remote/Nationwide

About You

You are a person who loves to assist in maintaining overall quality management for Revenue Cycle Management (RCM) team functions. In the role of Revenue Cycle QA Specialist, you will be responsible for completing audits on work that involves prior authorization, billing, collection/follow-up, payments, refunds, or denials.

• Tell us about your experience with Quality Assurance.
• Are you a team player and a self-motivator?
• What is your experience with conducting business in a way that is credit to a company?
• We are counting on you to manage multiple projects using your problem-solving skills.
• We are looking for someone UNCOMMON. What is uncommon about you?

Are you highly committed? Are you team-oriented? Do you value professionalism, trust, honesty, and integrity? If so, we cannot wait to meet you.

About The Position

• Performs initial and regular audits on RCM team members for accuracy and compliance to department policies and procedures, and industry practices.
• Maintains proficiency in policy and procedures including updates and changes
• Develops error tracking systems and data elements used to as QA criteria and scoring
• Creates reports to track and monitor QA standards.
• Supports Creation of tip sheets for all staff members to help eliminate common errors or to address the work around processes for system limitations.
• Provides timely feedback on QA activities to associate's manager/supervisor.
• Responsible for providing industry metrics on productivity standards and establishes quality assurance protocols.
• Assists operations management with training needs, coordinating enhancements or needs assessments that are consistent with department policies and procedures.
• Works collaboratively with RCM leadership in the development of Performance Improvement coaching and education plans for those staff members that do not meet the minimum requirements on the individual QA scores.
• Participates in performance improvement through assisting with the implementation of policies and procedures, productivity standards, planning and implementing change and maintaining and improving productivity through attendance and participation in staff meetings, committees, tasks forces, cross-functional groups, projects and discussion with hospital and medical staff as observed by supervisor.
• Demonstrates thorough knowledge of hospital and clinic billing requirements, health insurance reimbursement principles, client-specific policy and procedures.
• Performs regular QA leveling exercises to assure all team members performing QA audits are consistently applying same scoring and methodologies.
• Remains updated on payer requirements, coding guidelines, and industry trends to inform training and QA efforts.
• Regular attendance at work is an essential function of the job.

Minimum Requirements:

• High School Diploma or GED equivalent Required and
• Associate's Degree in Billing, Coding, Business, or related field Required
• 2-4 years of experience working with commercial, government billing or reimbursement processes may be substituted for education.
• Strong understanding of the end-to-end revenue cycle, including patient access, claims management, hospital and professional billing, and collections.
• Knowledge of CPT, HCPCS and revenue codes and their effect on reimbursement.
• 2-4 years Experience in auditing, quality assurance, and training within a healthcare or insurance setting is often required.
• Ability to communicate effectively both verbally and in writing.
• Proficiency in relevant software systems and Microsoft Office Suite is typically expected.
• Strong analytical, communication, and interpersonal skills are essential for effective training and collaboration.
• Organized, self-motivated and able to work independently of direct supervision to carry out responsibilities.
• Familiarity with specific Electronic Health Record (EHR) systems like Epic, Oracle, and Meditech is preferred.

About Us

You are uncommon. We are, too. We are looking for people to help us in our mission of working hard at lowering healthcare administrative costs for federal government agencies, payers, and providers. At Signature, our mission is to improve the health of our clients' business and make the lives of the people we work with better. As we continue to experience exponential growth, we are looking for uncommon individuals to enhance our vision. We will continue to accomplish our mission by leading with our values of Passion, Courage, Integrity, and Respect in all interactions, making us a consistent annual Best Places to Work organization. We need uncommon leaders with uncommon qualities to shape our uncommon culture and achieve our uncommon mission.

About the Benefits

When you are a member of Signature Performance, you are a part of a solutions-based organization where the values of passion, integrity, courage, and respect are the driving forces behind all our decision-making. We trust you to do important work and bring the best version of yourself to work every day, so we want to help you achieve a work-life balance while consistently challenging yourself. Signature believes in fully developing each one of our Associates. Our performance-driven philosophy boasts competitive pay and additional position specific incentives, where world-class training and development, resources, and events drive our award-winning culture where everyone thrives.

• Health Insurance
• Fully Paid Life Insurance
• Fully Paid Short- & Long-Term Disability
• Paid Vacation
• Paid Sick Leave
• Paid Holidays
• Professional Development and Tuition Assistance Program
• 401(k) Program with Employer Match

• U.S. Citizenship or naturalized citizenship is required for this position.
• All work on all positions at Signature Performance must be completed in the continental United States, Alaska, or Hawaii.