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.

Schedule: Full-time

Shift: Monday-Friday

Job Location: Virtual

The role you’ll 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’ll 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

The expertise and experiences you’ll need to succeed:

Minimum qualifications:

• Associates Degree in business, Accounting, Finance, Health Administration, or another related field OR two (2) years of relevant experience
• One (1) experience in healthcare or related field, with specific emphasis on billing, charging or coding

Preferred qualifications:

• Four (4) years of experience in revenue cycle processes. Hospital coding, billing or healthcare finance background preferred
• Knowledge of Medicare, Medicaid, and other third-party payers billing and reimbursement regulations/policies, preferred
• Lean and Six Sigma Certification
• Quality Assurance Certification
• Knowledge of Epic and associated applications leveraged within the Revenue Cycle functions