Revenue Cycle QA Auditor

About the Job

Welcome to Ovation Healthcare! 

At Ovation Healthcare (formerly QHR Health), we’ve been making local healthcare better for more than 40 years. Our mission is to strengthen independent community healthcare. We provide independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong sense of purpose and commitment to operating excellence, we help rural healthcare providers fulfill their missions.  

The Ovation Healthcare difference is the extraordinary combination of operations experience and consulting guidance that fulfills our mission of creating a sustainable future for healthcare organizations. Ovation Healthcare’s vision is to be a dynamic, integrated professional services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer focused behavior.  

We’re looking for talented, motivated professionals with a desire to help independent hospitals thrive. Working with Ovation Healthcare, you will have the opportunity to collaborate with highly skilled subject matter specialists and operations executives, in a collegial atmosphere of professionalism and teamwork.  

Ovation Healthcare’s corporate headquarters is located in Brentwood, TN. For more information, visit www.ovationhc.com.  

Summary:

The Revenue Cycle QA Auditor, reflects the mission, vision, and values of Resolution RCM, adheres to the organization’s Code of Ethics and Corporate Compliance Program, and complies with all relevant policies, procedures, guidelines and all other regulatory and accreditation standards. This position will report to the Education and Quality Director.

Responsibilities

• Responsible for providing quality audit services to evaluate and improve Revenue Cycle performance.
• Ensures that all quality audits are completed accurately, objectively, and in a timely manner.
• Completes all necessary documentation to support audit work.
• Creates performance reports for staff, department, and leadership as required.
• Identifies and produces reports for overall quality trends and provides input to Education and Quality Director, for training and development.
• Makes recommendations for the development of action plans with trainers, Managers, and/or Team Leads.
• Processes audit disputes, providing thorough and timely feedback to management and Education and Quality Director.
• Manages internal customer relationships and follows issues through to closure.
• Completes other duties assigned by Education and Quality Director.

Additional Functions

• Coordinates audit schedule to ensure compliance with quality audit procedures for staff and departments.
• Completes all supporting information and documentation required for individual and departmental reporting.
• Designs and produces reports and individual quality scorecards as required.
• Provides input to Education and Quality Director for department policies and procedures.
• Consistently communicates quality audit results to appropriate Manager, Team Lead and/or Staff.
• Ensure compliance with quality sign off and documentation procedures for Quality Auditors, Department Manager, and Team Lead.
• Assesses and communicates staff development needs to Education and Quality Director and training team.
• Assists with development of training material based on trends identified in monthly audits.
• On occasion may assist with the training of staff based on trends identified.

Required Skills and Experience

• Minimum five (5) years of general hospital business office billing and collections experience
• Understands A/R management concepts for CAH/general hospital, and business office operations
• Expert level billing and/or collections with Medicare, Medicaid, commercial and/or self-pay
• Medical billing software expertise in (but not limited to): Meditech (MAGIC, Client Server or Expanse), CPSI, Medhost, EPIC, Meditech, Rycan, Emdeon, Change, Relay Health, Trubridge, Athena, etc.)
• Excellent written and verbal skills and demonstrates the ability to manage workload and prioritize while multi-tasking in a fast-paced environment
• Must possess excellent people skills
• Critical thinking skills
• Strong computer skills (Word, Excel, PowerPoint)
• Strong leadership, organization, planning and time management skills.
• Strong ability to grasp new concepts and apply them.
• Strong ability to understand complex workflows and follow procedures

Education:

• High School Diploma or GED required, college degree or some college preferred
• Additional certification/training via CMS MedLearn, HFMA, AHAM, AMA preferred

Benefits

The base compensation range for this position is:

Compensation ranges could be hourly or salary depending upon the exempt status of the posted position.

Beginning compensation is determined based on objective factors such as location, qualifications, skills, certifications, and experience. Typically, a candidate is hired in the lower to midpoint of the range; the top end of the range is reserved for candidates with extensive specialized experience and mastery within the role. Compensation may increase over time based on performance, experience, and tenure.

Compensation is only part of Ovation's total compensation package. Some additional benefits offered to full-time associates are:

• Comprehensive health and wellness benefits such as medical, dental, vision, life insurance, short and long-term disability coverage
• HSA with employer contributions, flexible spending accounts for health care, and dependent care accounts
• Wellness platform with premium incentives
• Employee assistance support and additional voluntary supplemental plans including accident, critical illness, hospital indemnity, and child disability insurance
• Robust and flexible paid time off offerings and company paid holidays
• 401(k) plan with discretionary employer match opportunities
• Professional development opportunities
• Company issued equipment