Quality Specialist

2025-01-09 | Ensemble Health Partners | Remote |  | United States

Perks & Benefits:

Location:
Remote
Privileges:
  • Tuition reimbursement
Thank you for considering a career at Ensemble Health Partners!
Ensemble Health Partners is a leading provider of technology-enabled revenue cycle management solutions for health systems, including hospitals and affiliated physician groups. They offer end-to-end revenue cycle solutions as well as a comprehensive suite of point solutions to clients across the country.
Ensemble keeps communities healthy by keeping hospitals healthy. We recognize that healthcare requires a human touch, and we believe that every touch should be meaningful. This is why our people are the most important part of who we are. By empowering them to challenge the status quo, we know they will be the difference
The Opportunity:
CAREER OPPORTUNITY OFFERING
  • Bonus Incentives
  • Paid Certifications
  • Tuition Reimbursement
  • Comprehensive Benefits
  • Career Advancement
  • This position pays between $16.00 - $20.00/hr based on experience
The Quality Specialist will play an essential role in reviewing and ensuring the quality of the Revenue Cycle teams’ work efforts. The primary responsibility of this role is to perform independent account reviews that have been worked by our Revenue Cycle team members with the purpose of identifying opportunity and making recommendations for improvement to the operational and executive leaders.
Essential Job Functions:
  • This role will assist Leadership with continued training, education and ongoing action plans to ensure quality is consistently met for existing teams in partnership with the Sr Quality Specialist and Leadership Team. In addition, this role will assist the Sr Quality Specialist and Leadership Team with onboarding support including user provisioning as required.
  • Assesses the Quality Assurance process and actively looks for opportunities to increase efficiency and proactively brings to Leadership attention.
  • Evaluate operational and management Quality Audit policies/procedures and provide input into the annual review workplan.
  • Performs Quality reviews across multiple clients, working in a variety of host systems.
  • Coordinate with service line leaders and partner with upper-level Leadership, to identify areas of risk and assist leadership in developing a quarterly/ annual review plan.
  • Develop a thorough understanding of business processes in scope for assigned reviews and document the processes.
  • Perform account level review to ensure consistency with best practices including but not limited to Quality Audit to confirm implementation and effectiveness of policies/procedures.
  • Perform reviews to measure compliance with policies, procedures, workflow, and other applicable requirements.
  • Identify and document operational, compliance, and quality risks and make recommendations to mitigate risks.
  • Prepare and assist in presenting quality reports of review findings and recommendations to direct leadership for review and approval.
  • Participate in pre- & post-review meetings, providing support and recommendations for issues presented.
  • Ensure past review recommendations are implemented in current review process.
  • Maintain current knowledge of laws/regulations regarding medical necessity, clinical documentation, compliance standards, other general clinical and/or business matters related to the service line they are working.
Required Job Experience:
  • 5 to 7 Years experience in Quality Assurance
  • At least 3 years Accounts Receivable experience
  • Epic Payment system experience
  • Revenue Cycle Management experience
Required Education Level:
  • Associates Degree or Equivalent Experience
Required Certifications:
  • CRCR, either upon hire or within 9 months of hire.
Join an award-winning company
Three-time winner of “Best in KLAS” 2020-2022
2022 Top Workplaces Healthcare Industry Award
2022 Top Workplaces USA Award
2022 Top Workplaces Culture Excellence Awards
  • Innovation
  • Work-Life Flexibility
  • Leadership
  • Purpose + Values
Bottom line, we believe in empowering people and giving them the tools and resources needed to thrive. A few of those include:
  • Associate Benefits – We offer a comprehensive benefits package designed to support the physical, emotional, and financial health of you and your family, including healthcare, time off, retirement, and well-being programs.
  • Our Culture – Ensemble is a place where associates can do their best work and be their best selves. We put people first, last and always. Our culture is rooted in collaboration, growth, and innovation.
  • Growth – We invest in your professional development. Each associate will earn a professional certification relevant to their field and can obtain tuition reimbursement.
  • Recognition – We offer quarterly and annual incentive programs for all employees who go beyond and keep raising the bar for themselves and the company.
Ensemble Health Partners is an equal employment opportunity employer. It is our policy not to discriminate against any applicant or employee based on race, color, sex, sexual orientation, gender, gender identity, religion, national origin, age, disability, military or veteran status, genetic information or any other basis protected by applicable federal, state, or local laws. Ensemble Health Partners also prohibits harassment of applicants or employees based on any of these protected categories.
Ensemble Health Partners provides reasonable accommodations to qualified individuals with disabilities in accordance with the Americans with Disabilities Act and applicable state and local law. If you require accommodation in the application process, please contact .
This posting addresses state specific requirements to provide pay transparency. Compensation decisions consider many job-related factors, including but not limited to geographic location; knowledge; skills; relevant experience; education; licensure; internal equity; time in position. A candidate entry rate of pay does not typically fall at the minimum or maximum of the role’s range.
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