Quality Specialist

Quality Specialist-20928 – Rush University Medical Center

Location:

Chicago, Illinois

Work Type:
Full Time (FTE 0.9–1.0)

Shift: 8:00 AM – 4:30 PM (8 hours)

Pay Range: $20.19 – $31.80 per hour

Benefits:
Rush offers a comprehensive benefits package. Learn more.

The Quality Assurance (QA) Specialist is responsible for performing quality monitoring to ensure Patient Access staff adhere to expected workflows, internal policies, registration processes across the organization, and external regulatory requirements. The QA Specialist is a remote position supporting across departmental processes. This position will work closely with Patient Access leadership to provide support for both on‑site and remote staff, exemplifying Rush’s mission, vision, and values and acting in accordance with Rush policies and procedures.

• High school graduate or equivalent
• 1-2 years of experience
• Experience with in a hospital or clinic environment, a health insurance company, managed care organization, or other healthcare financial service setting
• Basic understanding of core Microsoft Office suite (Word, PowerPoint, Excel)
• Excellent communication and outstanding customer service and listing skills
• Basic keyboarding skills
• Ability to analyze and interpret data
• Critical thinking, sound judgment, and strong problem‑solving skills
• Team oriented, open minded, flexible, and willing to learn
• Strong attention to detail and accuracy required
• Ability to prioritize and function effectively, efficiently, and accurately in a multi‑tasking, complex, fast‑paced, and challenging department
• Ability to follow oral and written instructions and established procedures
• Ability to function independently and manage own time and work tasks
• Ability to maintain accuracy and consistency
• Ability to maintain confidentiality

• Associate's Degree in Accounting or Business Administration
• Working knowledge of medical terminology and anatomy and physiology

Physical Demands:
Not applicable; general requirements for the job. The above is intended to describe the general content and requirements of the position.

Disclaimer:
The above is not an exhaustive statement of duties, responsibilities, or requirements.

• Provide ongoing monitoring to compile and track performance at the team and individual level, and provide trend data to the management team.
• Prepare and analyze internal and external quality reports for management staff to review – including high dollar accounts, aged accounts, guarantor change account, CEA report, claim edits, DNB accounts.
• Work newborn accounts – monitor the addition of insurance for newborn coverage.
• Review prior account notes for past due balances and any information that might aid in the account resolution process, document all encounters and actions, and follow up with responsible persons for updates.
• Monitor daily metrics dashboard for additional accounts that may impact overall unresolved accounts, affecting department metrics for DNFB, claim edits, and CFB days.
• Exercise exceptional customer service skills when communicating with team members and internal customers, finding resolution within phone interactions or escalating appropriately.
• Interact and collaborate with numerous departments to resolve issues while analyzing necessary information that ensures hospital reimbursement.
• Initiate requests for financial program compliance and other policies to ensure adherence, protecting HIPAA confidential medical information.
• Attend regular EPIC training sessions or other sessions for associates involved in financial counseling functions.
• Perform other duties as needed and assigned by supervisor/manager.

Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.