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ECU Health · 5 hours ago

Revenue Cycle Quality Assurance Analyst

Greenville, NC

Full-time

Onsite

Mid Level

3+ years exp

ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The Revenue Cycle Quality Assurance Analyst is responsible for evaluating the accuracy, completeness, and compliance of daily account activity completed by Patient Access, Billing, Follow-Up, and Denial Management staff, while identifying error trends and recommending process improvements.

Hospital & Health Care

Responsibilities

Conduct daily and/or weekly audits of accounts worked by Patient Access Representatives, Billing Specialists, Follow-Up Representatives, and Denial Specialists

Validate accuracy of demographic, insurance, and authorization data entered during patient access processes

Review billing and claim submission activity for completeness, coding accuracy, and adherence to payer-specific rules

Assess follow-up actions for timeliness, accuracy, and effectiveness in resolving outstanding balances

Evaluate denial management work for correct root cause identification, appeal quality, and compliance with denial resolution workflows

Document audit findings and prepare detailed quality reports for leadership review

Identify recurring errors or gaps in processes and communicate actionable recommendations to department managers

Develop and deliver feedback to staff in collaboration with team leaders, supervisors, managers and directors to drive performance improvement

Partner with Revenue Cycle leadership to design corrective action plans based on QA results

Collaborate with training teams to address common errors through targeted education sessions

Assist in developing and refining quality monitoring tools, scorecards, and standard operating procedures

Ensure all account work complies with HIPAA, CMS guidelines, payer policies, and internal revenue cycle standards

Support the onboarding of new staff by participating in competency assessments and feedback sessions

Serve as a subject matter expert (SME) for quality review standards within the revenue cycle

Support readiness for external audits by maintaining accurate QA documentation

Monitor adherence to key organizational KPIs for quality and compliance

Qualification

Revenue cycle workflowsAuditing experienceEHRBilling systemsData analysisAttention to detailAnalytical skillsMicrosoft Office SuiteOrganizational skillsProblem-solving skillsCommunication skills

Required

Associate's degree in healthcare administration, Business, or related field required; and/or Equivalent work experience may be considered in lieu of a degree

Minimum of 3 years of experience in hospital or physician revenue cycle operations, with exposure to Patient Access, Billing, Follow-Up, and Denial Management workflows

Strong knowledge of revenue cycle workflows, payer requirements, and regulatory guidelines

High attention to detail with the ability to identify trends and root causes of errors

Excellent organizational, analytical, and problem-solving skills

Proficient in Microsoft Office Suite, particularly Excel, for data analysis and reporting

Strong verbal and written communication skills with ability to convey findings clearly