RIQA QA Analyst

Profile

Overview

To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values - integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.

The Receivable Integrity Quality Assurance Analyst reports to the Manager of Quality/Denials and is responsible for retrospective reviews of accounts and workflows within the revenue cycle. As part of the receivable integrity review, the Quality Assurance Analyst is responsible for analyzing accounts, identifying trends as well as documenting the root cause of delays observed. Performs detailed account reviews utilizing in-depth knowledge of the entire revenue cycle. Works collaboratively within the team to ensure consistent philosophies are applied as it pertains to best practices. Summarizes findings and compiles summarized data for review with QA leadership. Recommends procedure modifications and process improvement ideas to support Revenue Cycle Quality Monitoring initiatives. Assists in other department task to support all receivable Integrity initiatives

EEO/AA/Disability/Veteran Responsibilities

1. Retrospectively analyzes accounts to identify trends in the revenue cycle that may negatively impact the Account Receivable and prepares summaries of findings. Identify trends/ issues within the revenue cycle through targeted projects. Provides accurate account assessments to ensure precise QA feedback.

2. Performs detailed, analytical account reviews in a timely manner. Provides quality feedback and accurate assessment of accounts. Documents findings in a clear and concise manner while making recommendations for improved reporting. Assists with project tracking and provides feedback related to completions timeframes.

3. Works collaboratively within the Receivable Integrity QA team to determine best practices within the QA process. Shares knowledge pertaining to Revenue cycle workflows to help achieve consistency within QA reviews amongst peers.

4. Introduces new projects and tasks to others within the department, explaining procedures/policies to team members to ensure proper account resolution.

5. Demonstrates sound knowledge of the Epic Billing system as well as operational workflows within the entire revenue cycle.

6. Continually keeps abreast of technology changes, regulatory issues and payer requirements, sharing these with others as needed.

7. Performs all other duties as requested by the Supervisor or Manager to maintain a smooth operation of the department and contributes to group goals. The employee must also project a positive image of the department and the hospital.

Qualifications

EDUCATION

Bachelor's degree with major course work in Business Administration, Finance and /or Accounting or equivalent work experience in an Revenue Cycle environment.

EXPERIENCE

A minimum of three (3) years of billing, claims management or contract compliance experience in a hospital/healthcare computerized accounts receivable environment. Experience must include use of PCs.

SPECIAL SKILLS

Strong professional communication, organizational and time management skills. Must be proficient with software packages including spreadsheets, word processing and data base management. Extensive knowledge of Revenue Cycle workflows and operational procedures required. Demonstrated ability to analyze accounts and provide accurate summaries. Excellent analytical and mathematical skills with a high degree of accuracy required. Ability to perform detailed analysis quickly and accurately.

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Company info

The Westerly Hospital
Website : http://www.westerlyhospital.com