Quality Assurance Specialist I

Department:

13230 Enterprise Revenue Cycle - Enterprise PB Quality and Training Support

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

Full Remote.

M-F 8-5pm

Pay Range:

$22.90 - $34.35

Major Responsibilities:

Conduct quality assurance reviews across departments and payers to ensure billing accuracy and adherence to processes.

Analyze audit results to identify recurring issues, errors, and process gaps; recommend and support system or workflow improvements.

Validate Epic edits, payer configurations, and workflow updates to ensure accuracy and consistency across departments.

Maintain detailed records of audit outcomes and prepare actionable reports for leadership review and strategic planning.

Partner with leadership to identify trends and reduce preventable errors through targeted education.

Collaborate with training and leadership teams to support observation sessions and guide teammates requiring additional assistance, ensuring alignment with current SOPs and best practices.

Support the implementation of new processes, workflows, and tools designed to improve billing efficiency and accuracy.

Stay current on Advocate Health policies, Epic updates, and payer requirements.

Remain current with Advocate Health policies, Epic updates, and payer requirements to ensure continued compliance and operational readiness.

Licensure, Registration, and/or Certification Required:

None Required

Education Required:

High school diploma or GED required.

Experience Required:

Minimum 3 years of experience in billing operations workflows with a focus on quality.

Knowledge, Skills & Abilities Required:

Strong analytical and problem-solving skills, combining creativity and logical reasoning to troubleshoot issues and drive effective decision-making.

Excellent written and verbal communication skills; able to present complex information clearly to various audiences.

Thorough understanding of the healthcare revenue cycle - billing, denials, payer systems, and regulatory compliance - with a strong emphasis on quality assurance.

Proficient in Microsoft Office Suite (Excel, Word, PowerPoint), and quick to learn new technologies and systems, with experience using healthcare information systems.

Quick to learn new technologies and tools, with a proven ability to adapt to evolving systems and processes in support of quality monitoring and operational excellence.

Physical Requirements and Working Conditions:

Requires sitting for long periods of time. Requires bending and may need to lift-up to 10 pounds occasionally

Preferred Job Requirements

Preferred Certification/License/Registration

Preferred Education

Associate or bachelor's degree in healthcare administration, business, or related field preferred.

Preferred Experience

Preferred Knowledge/Skills/Abilities

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

Premium pay such as shift, on call, and more based on a teammate's job

Incentive pay for select positions

Opportunity for annual increases based on performance

Benefits and more

Paid Time Off programs

Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability

Flexible Spending Accounts for eligible health care and dependent care expenses

Family benefits such as adoption assistance and paid parental leave

Defined contribution retirement plans with employer match and other financial wellness programs

Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.

About Advocate Health

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.

The Quality Assurance Specialist plays a vital role in upholding quality standards within Patient Financial Services (PFS), working under the direct supervision of department leadership. This position demands strong analytical skills, attention to detail, and a deep understanding of revenue cycle processes. Core responsibilities include auditing follow-up representatives’ accounts, reviewing work queues, high-dollar accounts, and aged receivables, and supporting special projects assigned by leadership to strengthen operational integrity. The Quality Assurance Specialist I also develops reports and spreadsheets to identify system and process deficiencies, collaborates with cross-functional teams to address issues, and ensures compliance with billing regulations, payer requirements, and applicable standards.