Quality Analyst I - Clinical Practice Services

Summary

Responsible for conducting complex and large-scale audits to ensure the highest quality in billing, collections and reimbursement activities utilizing the Epic PB system and any other systems utilized. Scope of audits may span entire department and may interface with other departments and will include reviewing, creating and maintaining policies, procedures, and practices regarding billing, collections and reimbursement. Also serves as resource to leadership for any payor related issues identified.

Hybrid Position: 90% remote, 10% onsite

Primary Responsibilities

• Conducts quality assurance audits, ensuring standardization and compliance with established policies and procedures and applicable regulations.
• Prepares and presents quality and productivity reports to leaders.
• Identifies, researches, and documents process improvement opportunities and coordinates improvement activities and provides best practice coaching to staff.
• Identifies and recommends workflows in need of standardization, convenes area experts, and coordinates improvement activities necessary to develop standards.
• Identifies and recommends areas for staff education and prepares educational training materials in coordination with training team.
• Responsible for creating, maintaining and communicating all department policy and procedures.
• Function as back-up for leadership for related audit issues and in meetings as needed.
• Serve as liaison to Clinical Department & CP leadership on all billing, collection and reimbursement issues.
• Assists in the validation of billing software and practices to ensure quality standards are met. Serve as liaison to Clinical Department & CP leadership on all billing, collection and reimbursement issues.
• Respond to inquiries from billing, scheduling, and/or registration staff, or departments on appropriate procedures related to the billing of medical services.
• Other duties as assigned.
  
  

Knowledge – Skills – Abilities

• Knowledge of technical, business, consultation, project management, and cultural awareness.
• Customer focus, building trust, communication, critical thinking, and influencing skills.
• Epic Professional Billing subject matter expert for billing, collections and reimbursement, and overall revenue cycle processes
  
  

Qualifications

Appropriate experience may be substituted for education on an equivalent basis.

Minimum Required Education: Bachelor’s degree

Minimum Required Experience: 5 years

Physical Requirements

Work requires occasionally lifting moderate weight materials, standing, or walking continuously.

Work Environment

Occasional exposure to dust, noise, temperature changes, or contact with water or other liquids. Work is performed in an environmentally controlled environment.

Sensory Acuity

Ability to detect and translate speech or other communication required. May occasionally require the ability to distinguish colors and perceive relative distances between objects.

Why MCW?

• Outstanding Healthcare Coverage, including but not limited to Health, Vision, and Dental. Along with Flexible Spending options
• 403B Retirement Package
• Competitive Vacation and Paid Holidays offered
• Tuition Reimbursement
• Paid Parental Leave
• Employee & Family Assistance Program (EFAP)
• Pet Insurance
• On campus Fitness Facility, offering onsite classes
• Additional discounted rates on items such as: Select cell phone plans, local fitness facilities, Milwaukee recreation and entertainment etc.
  
  

For a brief overview of our benefits see: Benefits Overview

For a full list of positions see: MCW Careers

At MCW all of our endeavors, from our internal operations to our interactions with our partners, are driven by our shared organizational values: Caring – Collaborative – Curiosity – Inclusive – Integrity – Respect. We are committed to fostering an inclusive environment that values diversity in backgrounds, experiences, and perspectives through merit-based processes and in alignment with all applicable laws. We believe that embracing human differences is critical to realize our vision of a healthier world, and we recognize that a healthy and thriving community starts from within. Our values define who we are, what we stand for and how we conduct ourselves at MCW. If you believe in embracing individuality and working together according to these principles to improve health for all, then MCW is the place for you. For more information, please visit our institutional website.

MCW as an Equal Opportunity Employer and Commitment to Non-Discrimination:

The Medical College of Wisconsin (MCW) is an Equal Opportunity Employer. We are committed to fostering an inclusive community of outstanding faculty, staff, and students, as well as ensuring equal educational opportunity, employment, and access to services, programs, and activities, without regard to an individual's race, color, national origin, religion, age, disability, sex, gender identity/expression, sexual orientation, marital status, pregnancy, predisposing genetic characteristic, or military status. Employees, students, applicants or other members of the MCW community (including but not limited to vendors, visitors, and guests) may not be subjected to harassment that is prohibited by law or treated adversely or retaliated against based upon a protected characteristic.