QA Analyst, Billing
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Job Location:
Alpharetta, GA - USA
Monthly Salary:
Not Disclosed
Posted on:
2 days ago
Vacancies:
1 Vacancy
Job Summary
For over 29 years Surgical Information Systems (SIS) has empowered surgical providers to Operate Smart by delivering innovative software and services that drive clinical financial and operational success. For ambulatory surgery centers (ASCs) SIS provides comprehensive software and services including ASC management electronic health records (EHRs) patient engagement capabilities compliance technology and revenue cycle management and transcription services all built specifically for ASCs. For hospital perioperative teams SIS offers an easy-to-use anesthesia information management system (AIMS).
Serving over 2700surgical facilities SIS is committed to delivering solutions that enable surgical providers to focus on what matters most: delivering exceptional patient care and outcomes.
Recognized as the No. 1 ASC EHR vendor by Black Book for 10 consecutive years and honored with the Best in KLAS Award for ASC Solutions in20252023 and2022 SIS remains the trusted choice for surgical providers seeking to enhance their performance.
Discover how SIS can help you Operate Smart at.
The QA Associate Billing is responsible for performing quality reviews of billing activities to ensure accuracy compliance and adherence to established workflows and client-specific requirements. This role supports the Revenue Cycle Services team by identifying errors documenting findings and contributing to continuous improvement efforts that reduce rework denials and revenue leakage for Ambulatory Surgery Center (ASC) clients.
Quality Audits & Review
- Perform routine quality audits on billing activities including charge entry claim creation claim submission and corrections.
- Validate accuracy of CPT/HCPCS codes modifiers diagnosis codes (as applicable) units and claim formatting.
- Ensure compliance with client-specific billing guidelines payer rules and internal SOPs.
- Apply established QA scorecards and error definitions consistently.
Documentation & Reporting
- Document audit results clearly including error categorization and supporting detail.
- Enter audit findings into QA tracking tools and dashboards.
- Escalate recurring or high-risk issues to the QA Manager per defined protocols.
Collaboration & Feedback
- Share audit feedback with billing team leads and supervisors in a constructive objective manner.
- Partner with Training Operations and QA leadership to highlight common error trends.
- Support retraining efforts by identifying opportunities for process clarification or standardization.
Continuous Improvement
- Track error trends and contribute insights to help reduce downstream denials and rework.
- Participate in calibration sessions to ensure scoring consistency across QA reviewers.
- Assist with updates to QA guidelines audit checklists and documentation as processes evolve.
Education & Experience
- Bachelors degree in Healthcare Administration Business Finance or related field or equivalent experience.
- 13 years of experience in healthcare revenue cycle billing.
- Experience in ASC billing is strongly preferred.
- Prior exposure to quality review auditing or compliance is a plus.
Technical & Functional Skills
- Working knowledge of:
- Medical billing workflows
- CPT HCPCS ICD-10 (basic to intermediate level)
- Payer claim submission requirements
- Experience with practice management and/or RCM systems.
- Strong attention to detail and accuracy.
BENEFITS:
- Benefit package including Medical Vision Dental Short Term Disability Long Term Disability and Life Insurance
- Vacation/Sick time
- 401(k) retirement plan with company match
- Paid Holidays
- SIS Cares Day
We believe employees are our greatest asset and we empower them to make a difference in our business. Diversity and inclusion makes us all better. Qualified applicants will receive consideration for employment without regard to race color religion sex national origin sexual orientation gender identity age disability protected veteran status and all other protected statuses.
Surgical Information Systems is an Equal Opportunity Employer and complies with applicable employment laws. M/F/D/V/SO are encouraged to apply.
At this time we are unable to sponsor H1B candidates
Required Experience:
IC
Key Skills
- LTC Pharmacy
- Accounts Receivable
- Medical Coding
- Accounting
- 10 Key Calculator
- Detailing
- Medical Billing
- Microsoft Excel
- CPT Coding
- Epic
- Medicare
- Contracts
About Company
Serving surgery providers for 20+ years, Surgical Information Systems offers software solutions and services for ambulatory surgery centers & hospitals.
