Sr. Specialist I, RCM Quality Assurance

Job Description:

The Sr. Specialist I, RCM Quality Assurance supports the Quality Assurance (QA) program across multiple locations. This role is responsible for executing QA processes, analyzing performance data, identifying trends, and contributing to continuous improvement efforts to ensure alignment with industry best practices and compliance standards.

• Coordinate and execute Quality Assurance activities such as sampling, status reporting, document archival, and process tracking.
• Support the QA Manager with operational tasks and ensure timely completion of quality review deliverables.
• Conduct quality assurance reviews and analyze results to identify performance gaps and recommend process improvements.
• Monitor program performance against service-level agreements and performance standards.
• Assist in developing action plans for performance improvement initiatives in collaboration with QA leadership.
• Conduct quality sampling and analyze workflow designs to identify trends and potential bottlenecks.
• Audit reports and analyze trends needing attention; escalate findings and insights to QA Manager.
• Contribute to cross-functional initiatives aimed at improving operational outcomes.
• Act as a liaison between QA and operational teams to incorporate feedback and improve service quality.
• Communicate program updates, changes in standard operating procedures, and directives to relevant stakeholders.
• Participate in continuous improvement efforts by identifying process gaps and proposing solutions.
• Ensure compliance with company standards, policies, and procedures; report deviations as needed.
• Regular communication/meetings with the Global Partners QA teams.
• Perform other duties that support the overall objective of the position.

Education Required:

• Associate degree with coursework in Business Administration or related field.
• Or, any combination of education and experience which would provide the required qualifications for the position.

Experience Required:

• 4+ years of experience in Revenue Cycle Systems and Operations or RCM Quality Assurance.
• Experience coordinating or leading projects or process improvement initiatives.

Knowledge, Skills & Abilities:

• Knowledge of: Proficient in Microsoft Office and audit/documentation systems.
• Skill in: Strong analytical, communication, and problem-solving skills. Effective in cross-functional collaboration and influencing without direct authority.
• Ability to: Work independently, prioritize tasks, and manage deadlines.

The company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employee's ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the company reserves the right to change this job description and/or assign tasks for the employee to perform, as the company may deem appropriate.

NextGen Healthcare is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.