RCM Quality Specialist

Additional Information About the Role

BJC HealthCare is looking for an RCM Quality Specialist! 

• This is a Full Remote Monday - Friday Role and will require ability to work independently, and have an understanding of medical insurance and billing/follow up processes. 
• This role will be in charge of developing training documents, creating score cards and work with Revenue Cycle Management teams. 
• Complete audits to improve performance. 
• Follow up on billing issues and work on special projects(ex: Denial Prevention Task Force) 
• Ideal candidates will have a high level of attention and previous background in RCM or Patient Access. 

Overview

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St. Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations. Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay. In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.

BJC’s patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St. Louis Children’s Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country.

Preferred Qualifications

Role Purpose

The RCM Quality and Training function ensures RCM team members have the standard work, knowledge, skills, feedback, and resources to be successful. Quality drives the training content, and training ensures quality standards are met.The RCM Quality Specialist has revenue cycle subject matter expertise, specifically in patient access and revenue management, along with an inherent ability to analyze and improve individual team member performance gaps as well as broader, systemic quality gaps.Implements and manages department-level elements of RCM’s quality management system. Is responsible for developing resources and facilitating processes for audits of individual team member performance as well as team level quality. Uses analytic reports to identify broader trends in quality gaps; collaborates with appropriate peers and leaders to identify root causes, develops potential mitigation plans, and implements those plans.Develops and updates standard work documentation; ensures updates are communicated to all appropriate team members and is incorporated into training materials.

Responsibilities

• Partners with leaders to identify metrics at the individual team member level and at the team-level. These metrics will drive data collection strategy, training content, mitigation planning, and changes to workflows and standard work.
• Develops and continuously improves RCM’s quality management systems, for individual team member performance audits/mitigation plans and team-level quality audits/mitigation plans.
• In collaboration with training specialists and preceptors, conducts performance audits on team members. Communicates performance and quality gaps with RCM leaders.
• Accesses individual team member performance reports and quality analytic reports to identify trends in gaps. Collaborates with leaders and training specialists to analyze the root causes of gaps. Works with appropriate leaders to develop and implement mitigation plans. Identifies trends that may require additional training focus, standard work modification, etc.
• Collaborates with training specialists and department leaders to ensure documented, easily accessible, current, thorough and accurate standard work (such as policies, procedures, and work flows) is in place for each job role. Incorporates standard work into training courses and materials. Builds consistency across departments.

Minimum Requirements

Education

• Associate's Degree

Experience

• 2-5 years

Preferred Requirements

Education

• Bachelor's Degree

Experience

• 5-10 years

Supervisor Experience

• No Experience

Benefits and Legal Statement

BJC Total Rewards

At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.

• Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date
• Disability insurance* paid for by BJC
• Annual 4% BJC Automatic Retirement Contribution
• 401(k) plan with BJC match
• Tuition Assistance available on first day
• BJC Institute for Learning and Development
• Health Care and Dependent Care Flexible Spending Accounts
• Paid Time Off benefit combines vacation, sick days, holidays and personal time
• Adoption assistance

To learn more, go to our Benefits Summary.

*Not all benefits apply to all jobs

The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job. Equal Opportunity Employer