Revenue Cycle QA Auditor

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 Ovation Healthcare, 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.

Duties and 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.
• Complete all necessary documentation to support audit work.
• Create 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.
• Manages internal customer relationships and follows issues through to closure.
• 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 the 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, Quality Director, and training team.
• Assists with the development of training material based on trends identified in monthly audits.
• May occasionally assist with the training of staff based on trends identified.

Knowledge, Skills and Abilities:

• 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.

Work Experience, Education and Certifications:

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

Working Conditions and Physical Requirements:

• 100% Remote

Travel Requirements:

• 0%