Job description

About the Department and Role

This position is within the Enterprise Revenue Cycle's Enterprise PB Quality and Training Support team and offers full-time employment with benefits. The role operates on a standard Monday to Friday schedule from 8:00 AM to 5:00 PM, working fully remotely. The Quality Assurance Specialist plays a key role in maintaining the highest quality standards in Patient Financial Services, operating under direct supervision of department leadership.

Key Responsibilities

Perform quality assurance audits across various departments and payer systems to verify billing accuracy and adherence to protocols.
Examine audit data to detect recurring errors and process inefficiencies, proposing system or workflow improvements as necessary.
Verify changes in Epic systems, payer setups, and workflow modifications for consistency and correctness across teams.
Keep thorough documentation of audit results and prepare reports that inform leadership and aid in strategic decisions.
Collaborate with departmental leadership to identify trends and implement targeted training to reduce avoidable errors.
Work closely with training and leadership teams to support observation sessions and assist team members needing further guidance, ensuring compliance with current SOPs and best practices.
Assist in rolling out new processes, workflows, and tools aimed at enhancing billing effectiveness and correctness.
Stay updated with Advocate Health policies, Epic system enhancements, and payer requirements to maintain compliance and operational readiness.
Audit account follow-ups, review work queues, high-value accounts, and aged receivables as part of continuous quality monitoring.
Develop analytical reports and spreadsheets to identify and address systemic process issues.
Coordinate with cross-functional teams to resolve detected problems and ensure adherence to billing regulations and payer standards.

Experience and Qualifications

High school diploma or GED is required; an associate's or bachelor's degree in healthcare administration, business, or related fields is preferred.
A minimum of three years' experience in billing operations focusing on quality assurance is essential.
Strong analytical and problem-solving skills capable of applying both innovative and logical approaches to troubleshooting.
Excellent communication skills, both written and verbal, to clearly present complex information to diverse audiences.
In-depth knowledge of healthcare revenue cycle operations, including billing, denials, payer systems, and regulatory requirements, emphasizing quality standards.
Proficiency in Microsoft Office applications (Excel, Word, PowerPoint) and demonstrated ability to quickly learn new technologies and healthcare information systems.
Ability to adapt to evolving tools and systems in support of quality assurance and operational excellence.

Physical and Work Environment

This position requires prolonged periods of sitting, occasional bending, and the ability to lift up to 10 pounds as needed.

Additional Information

The role offers a competitive salary range of $22.90 to $34.35 per hour, with base pay determined by candidate qualifications, experience, and skills. Advocate Health provides a comprehensive Total Rewards package including paid time off, medical and wellness benefits, flexible spending accounts, family support benefits such as adoption assistance and paid parental leave, retirement plans with employer contributions, and educational assistance programs. The eligibility for benefits may depend on employment status.

Advocate Health is recognized as the third-largest nonprofit integrated health system in the U.S., noted for clinical innovation and exceptional health outcomes. The system serves nearly six million patients across multiple states, operating more than 69 hospitals and 1,000 care locations, supported by extensive graduate medical education programs.

Other duties may be assigned in line with the general role of quality assurance within revenue cycle operations.

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