AdventHealth Corporate

All the benefits and perks you need for you and your family:

·    Benefits from Day One

·    Career Development

·    Whole Person Wellbeing Resources

·    Mental Health Resources and Support

Our promise to you:

Joining AdventHealth is about being part

of something bigger. It’s about belonging to a community that believes in the wholeness of each person, and serves to uplift others in body, mind and spirit. AdventHealth is a place where you can thrive professionally, and grow spiritually, by Extending the Healing Ministry of Christ. Where you will be valued for who you are and the unique experiences you bring to our purpose-minded team. All while understanding that together we are even better.

Shift:  Full-time; Monday-Friday    

 

Job Location: Remote

 

The role you will contribute:

 

'The Process Improvement and Business Support team's Middle Revenue Cycle Quality Audit (QA) Analyst supports the operations of the Middle Quality Audit, Training, and Education team by completing both overall and account-level quality reviews of functional areas across the middle revenue cycle. Quality audits are inclusive of assessing staff adherence to middle revenue cycle policies, procedures, and guidelines established by the respective department. The role will conduct root cause analysis to understand key issues and operational risks to help drive targeted improvements in the middle revenue cycle to support improvement across the end-to-end Revenue Cycle functions for all AdventHealth Acute operations. The Middle Revenue Cycle Quality Audit Analysts will be responsible for quality audits that focus on assessing medical records to verify charges are supported by documentation, identification of charging opportunities and / or inaccuracies by comparing medical record documentation to itemized bill to identify charging and billing weaknesses within the system, and review of clinical department adherence to charge reconciliation. This role involves extensive collaboration with other Process Improvement and Business Support functional areas, including but not limited to Training and Education, Analytics, Vendor Management, Automation, and Revenue Cycle and System SMEs (Subject Matter Experts) team. The Middle Revenue Cycle Quality Audit Analyst will adhere to AdventHealth Corporate Compliance standards, as well as rules and regulations of all applicable local, state, and federal agencies and accrediting bodies.'

 

The value you will bring to the team:

Completes timely and accurate quality audit reviews while adhering to revenue cycle policies, procedures, and established audit schedule specifically within the middle revenue cycle office functions; provides practical recommendations for improvements in further standardizing audit policies and procedures

Provides outcomes of quality audit reviews with Middle Revenue Cycle department leadership as well communication with clinical departments, where applicable, through various methods of communication including but not limited to email and presentations

Reviews dashboards with the Quality Audit, Training, Education Supervisor to discuss key findings that inform and drive continuous education

Conducts extensive root cause analysis (based on dashboard and account reviews) to determine key issues and translates quality auditing results into actionable recommendations for improvement, relays findings and recommended action plan with the Quality Audit, Training, Education Supervisor

Collaborates with the Analytics team to decide which QA metrics will be tracked and visualized on shared dashboards to report outcomes, and improve processes and workflows including programming requests, process changes, and staff accuracy and efficiencies

Collaborates with the Vendor Management team to share business requirements to improve performance and process adherence, and to track quality data

Collaborates with Trainers and Educators as well as coordinate with Middle Cycle leadership in assessing areas of improvement based on quality review results and determines training needs, quality/training tools and program materials; shares leading practice workflows across different departments and regions to drive continuous improvement

Supports the Trainers and Educators to meet with new Middle Cycle hires within their first 90 days to ensure audits conducted are comprehensive and meet service level agreements

Attends and participates in Middle Revenue Cycle department meetings with leaders and front-line staff as needed

Collaborates with CBO (Centralized Business Office) leadership to review quality audit results and recommendations to deliver quality audit findings to Revenue Cycle teams

Collaborates with the Automation and Revenue Cycle and System SMEs team to provide ongoing recommendations on additional ways to drive efficiency for the Quality Audit operations across the enterprise

Monitors and processes, daily, weekly and/or monthly trend reports including, but not limited to, third party billing accuracy for hospitals services (e.g., work with CDM (Charge Description Master) coordinator to update CDM), adherence to service standards, and account compliance with regulatory agency requirements

 

 

The expertise and experiences you’ll need to succeed:

·        Associate's Degree in business, Accounting, Finance, Health Administration, or another related field OR two (2) years of relevant experience

·        1 experience in healthcare or related field, with specific emphasis on billing, charging or coding

·        Understanding of middle office Revenue Cycle process, charge trigger workflows including various tools and technologies leveraged by AdventHealth

·        Proficient knowledge of medical terminology, including Current Procedural Terminology (CPT) / Healthcare Common Procedure Coding System (HCPCS)

·        Exceptional problem-solving skills including working knowledge of revenue cycle processes, revenue integrity processes, and the components of a patient account

·        Demonstrates self-starter mentality, a quick thinker who is proactive and results oriented

·        Understanding of HIPAA privacy rules and ability to use discretion when discussing patient related information that is confidential in nature (as needed to perform duties)

·        Proficient in MS Office (Word, Excel, PowerPoint, Visio, Outlook, etc.) and familiarity with database programs

·        Ability to effectively learn and perform multiple tasks, and organize work in a systematic and efficient manner

·        Ability to communicate professionally and effectively in English, both verbally and in written form

·        Strong written and verbal communication skills

·        Ability to be responsive to ever-changing matrix of hospital needs and act accordingly

·        Ability to follow complex instructions and procedures, with close attention to detail

·        Knowledge of Epic and associated applications leveraged within the Revenue Cycle functions

·        Knowledge of Medicare, Medicaid, and other third-party payers billing and reimbursement regulations/policies

·        Lean Six Sigma Certification-IASSC

·        ECA Certified Quality Assurance Manager

 

Preferred Qualifications:

·        4 years of experience in revenue cycle processes. Hospital coding, billing or healthcare finance background  

 

This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances. The salary range reflects the anticipated base pay range for this position. Individual compensation is determined based on skills, experience and other relevant factors within this pay range. The minimums and maximums for each position may vary based on geographical location.

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