Lead Revenue Cycle Quality Auditor (Patient Access/Registration)

Overview

Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

Responsible for assisting the Integration & QA Coordinator in organizing and re-allocating work to team members in order to continue to perform and maintain the quality assurance processes for all registration reporting to the Patient Access Department and non-reporting sites across the organization.

Performs audits to ensure quality and compliance standards are met.

Responsibilities

 PRIMARY DUTIES AND RESPONSIBILITIES

Expert knowledge on all reports worked by the QA Auditor team.

Serves a guide to help new QA Auditors learn how to work the reports.

Under the direction of the coordinator, takes on additional reports that are not directly assigned that week in order to help get the team back on track.

In the absence of the coordinator and the manager, assigns and re-allocates work to team members accordingly when callouts arise.

Processes error disputes within quality assurance system, providing timely feedback to staff.

Performs account review for account financial resolution opportunities and performance opportunities.

Observes areas for operational flow opportunities.

Reviews patient satisfaction data and detail patient comments for feedback and QA application.

Performs compliance process audits, such as Important Message from Medicare, Medicaid plan application, Medicare Secondary Payer Questionnaire, Annual required signatures on file, etc. Includes Georgia Cancer Center and Atlanta Cancer Care sites.

Audits documents located in the imaging & account assigned system.

Performs audits of other nature, as assigned.

Reassigns scanned images, as needed.

Attends training team meetings.

Evaluates/Completes weekly quality report.  Analyzes trends in data, makes recommendations for training needs.

Performs duties of Patient Access Representative, Room Control Representative and Secretary/Scheduler and makes recommendations for training needs.

Review reports to reconcile and update patient account information between multiple systems.

Helps schedule and register accounts during acquisitions/onboarding.

Qualifications

REQUIRED:Bachelor's degree in Healthcare Management or related field

OR

Associate's degree in Healthcare Management or related field and two years of registration experience

OR

High School diploma or equivalent and three (3) years registration experience.

Functional knowledge of ADT and related systems

Excellent written and oral communication skills

Strong analytical, problem solving, trouble shooting skills

Skilled in the use and application of Microsoft Office Suite (Power Point, Word, Excel, Access, Outlook)  Ability to work independently

Demonstrated knowledge of healthcare operations, to include Patient Access product impact on reimbursement.

PREFERRED:1. Bachelor's degree in Healthcare Management or related field

2. Knowledge of Federal and State regulations

3. Knowledge of JCAHO requirements

4. Demonstrated knowledge of insurance verification, pre-cert, billing and collection procedures

5. Evidence of the ability to work well with others- a team player

6. Ability to organize and implement various programs

7. CHAA (Certified Healthcare Access Associate) or CPAR (Certified Patient Account Representative)

Work Hours (EX:7AM-7PM):

7AM-3:45PM

Weekend Requirements:

No

On-Call Requirements:

No