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Award-winning: Sentara is a Virginia and Northeastern North Carolina based not-for-profit integrated healthcare provider that has been in business for over 131 years. Offering more than 500 sites of care including 12 hospitals, PACE (Elder Care), home health, hospice, medical groups, imaging services, therapy, outpatient surgery centers, and an 858,000 member health plan. The people of the communities that we serve have nominated Sentara “Employer of Choice” for over ten years. U.S. News and World Report has recognized Sentara as having the Best Hospitals for 15+ years. Sentara offers professional development and a continued employment philosophy!
Sentara Health is seeking to hire a qualified individual to join our team as a Revenue Cycle QA Specialist
Position Status: Full-time, Day Shift
Position Location: This is a Hybrid position for residents of VA or North Carolina (traveling flexibility is required).
Position Summary:
Responsible for performing quality assurance reviews for assigned areas of the Revenue Cycle and Patient Access. Focus on improving the accuracy and productivity of all revenue cycle systems by assisting in facilitating, completing operations improvement projects, monitoring and improving quality of the patient account integrity.
Under the direction of the Revenue Cycle Education Leadership team, Revenue Cycle Quality Assurance Specialist will assist in data collection, data analysis, reporting, coordination of projects, assist in implementing processes, and communication of efforts.
Duties may include, but are not limited to, reviews of insurance and denials management processes, claim and account detail, assuring quality, accuracy, timeliness and appropriateness standards are maintained and quality standards measured and achieved. Serves as subject matter expert with regard to assigned revenue cycle systems and business processes used to ensure appropriate use and maximum efficiency. Performs process, operational and system workflow monitoring/reviews to ensure that efficient, cost effective work processes are being executed and/or creates tracking of areas that need to be addressed by management to optimize workflow, quality and performance.
Standard Working Hours: 8:00AM to 5:00PM (ET).
Minimum Requirements:
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Minimum of 2 years Registration, Billing or Collections experience required.
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Bachelor's Degree preferred.
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Hospital Billing experience, denials and follow-up
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Commercial Payers experience
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Knowledge of Revenue Cycle software systems required (HBOC, MCKESSON, EPIC PRELUDE/RESOLUTE). Must be proficient with EPIC – Grand Central/Prelude/Resolute and trained as a super user for HBOC.
Sentara Overview
For more than a decade, Modern Healthcare magazine has ranked Sentara Health as one of the nation's top integrated healthcare systems. That's because we are dedicated to growth, innovation, and patient safety at more than 300 sites of care in Virginia and northeastern North Carolina, including 12 acute care hospitals.
Sentara Benefits
As the third-largest employer in Virginia, Sentara Health was named by Forbes Magazine as one of America's best large employers. We offer a variety of amenities to our employees, including, but not limited to:
Medical, Dental, and Vision Insurance
- Paid Annual Leave, Sick Leave
- Flexible Spending Accounts
- Retirement funds with matching contribution
- Supplemental insurance policies, including legal, Life Insurance and AD&D among others
- Work Perks program including discounted movie and theme park tickets among other great deals
- Opportunities for further advancement within our organization
Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace. For information about our employee benefits, please visit: Benefits – Sentara (sentaracareers.com)
Please Note: The yearly Flu Vaccination is required for employment.
Note: Sentara Health offers employees comprehensive health care and retirement benefits designed with you and your family's well-being in mind. Our benefits packages are designed to change with you by meeting your needs now and anticipating what comes next. You have a variety of options for medical, dental and vision insurance, life insurance, disability, and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave. Team Members have the opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met.
When you join Sentara in a professional or management role, you become part of a progressive team of business leaders and operational experts. Our organization and our people are highly respected for the knowledge and innovation that we demonstrate each day. Working with us is an opportunity to have a positive influence on our growth and the communities we serve.
Culture In Action
At Sentara, our differences are our strengths. The unique backgrounds, skills, and experiences that each Sentara colleague brings to work are what make Sentara special and what allows us to deliver excellent service and care to our patients, members, and communities.
Sentara prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.