Revenue Cycle Quality Specialist - Remote

Major Responsibilities:
Develops and maintains a statistical database on all observed contacts/processes within assigned Revenue Cycle department to align with identified metrics. Makes recommendations on quality benchmarks and reports to evaluate and measure performance of programs and department processes and procedures.
Evaluates assigned Revenue Cycle department process, policy and workflow quality using standardized auditing tools for specific processes via random sample, ensuring quality and compliance goals are met.
Evaluates contact quality (i.e.: effective customer service, documentation, compliance, and cosmetics such as volume, rate, tone, enunciation, grammar, etc.) via random sample remote monitoring against quality standards, ensuring quality goals are met.
Facilitates and performs calibration sessions with team members and leaders to ensure quality programs are meeting the department requirements and workflow disparities are resolved through strong communication and partnership.
Performs focused compliance audits for specific revenue cycle processes to ensure federal regulations are followed.
Reviews and updates internal controls/workflow documents for respective areas.
Provides monthly/yearly statistical reports to leadership regarding quality of service results. Identifies and reports on trends, makes recommendations on changes and provides educational/coaching training and resources for department improvement.
Facilitates and provides ad hoc trend reporting and performance reports for leaders to review and address specific error trends. Presents at monthly system meetings with leadership teams to provide overarching system trend information and recommendations for training and workflow changes. Facilitates training and workflow updates in partnership with the training and process design teams.
Meets with leaders to review year over year performance data to support strategic planning and goal setting. Participates in and provides information for internal audit and risk teams regarding compliance such as PCI, HIPAA, 501r.
Licensure, Registration, and/or Certification Required:
None Required.
Education Required:
High School Graduate, or
Certificate of General Educational Development (GED) or High School Equivalency Diploma (HSED).
Experience Required:
Typically requires 5 years of experience in revenue cycle.
Knowledge, Skills & Abilities Required:
Diplomacy and tact in dealing with management, staff and customers.
Excellent written and verbal communication skills.
Demonstrated ability to identify gaps in service quality, problem solve and educate on quality/process improvement.
Ability to analyze trends and data and display in a statistical format.
Demonstrated proficiency in the use of Microsoft Office Excel, Access, and Word) or similar products. Ability to learn new systems as needed.
Physical Requirements and Working Conditions:
Occasionally lifts up to 10 lbs.
Exposed to a normal office environment.
Operates all equipment necessary to perform the job.
This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.