Sr. Quality Assurance Specialist

Site: North Shore Medical Center, Inc.

Mass General Brigham relies on a wide range of professionals, including doctors, nurses, business people, tech experts, researchers, and systems analysts to advance our mission. As a not-for-profit, we support patient care, research, teaching, and community service, striving to provide exceptional care. We believe that high-performing teams drive groundbreaking medical discoveries and invite all applicants to join us and experience what it means to be part of Mass General Brigham.

Job Summary

Summary
Responsible for ensuring the quality and accuracy of Patient Access Services (PAS) billing and claims processes. Performs quality assurance reviews, analyzes workflows, and collaborates with staff to ensure compliance with billing policies and improve patient access operations.

This role will provide oversight of the patient access service training and quality assurance processes to ensure materials are compliant and current with Epic and industry standards. Key areas of focus will include ensuring the quality of registrations across the hospital is meeting benchmarks to eliminate added volume in work queues and ensure efficient claim processing. Actively work in Epic software to review registration errors, authorizations and insurance claim edits. Identifies areas for improvement and develops, implements, maintains, and continuously evaluates the training program for patient access employees. This role will also serve as a subject matter expert and assist with Epic system upgrades and education and re-training of staff.

Does this position require Patient Care?
No

Essential Functions
-Designs and evaluates employee training programs to enhance accuracy, efficiency, and compliance.

-Conducts quality assurance reviews and audits to ensure compliance and identify improvement opportunities.

-Analyzes performance metrics and trends, providing actionable insights and reports to management.

-Maintains documentation of QA practices, procedures, and audit outcomes.

-Ensures regulatory compliance with federal, state, and organizational policies.

-Manages staffing logistics, including shift coverage and monthly scheduling.

-Supports timekeeping and approvals in UKG as a designated delegate.

-Provides cross-functional and real-time operational support across Patient Access areas, including ED Registration.

-Work alongside manager to ensure appropriate staffing and efficient workflows in patient areas.

Qualifications

Education Associate's Degree Healthcare Administration required or Associate's Degree Business required or Associate's Degree Related Field of Study required Can this role accept experience in lieu of a degree? Yes Licenses and Credentials Experience Experience in PAS, billing, or quality assurance 2-3 years required and Experience within a healthcare environment 2-3 years preferred Knowledge, Skills and Abilities - In-depth understanding of PAS billing, claims processing, and quality assurance practices. - Strong analytical skills, with the ability to identify trends and provide actionable insights. - Proficiency in using billing software and data analysis tools. - Effective communication skills, with the ability to train and collaborate with team members. - Detail-oriented with a strong focus on accuracy and compliance.

Additional Job Details (if applicable)

Physical Requirements Standing Occasionally (3-33%) Walking Occasionally (3-33%) Sitting Constantly (67-100%) Lifting Occasionally (3-33%) 20lbs - 35lbs Carrying Occasionally (3-33%) 20lbs - 35lbs Pushing Rarely (Less than 2%) Pulling Rarely (Less than 2%) Climbing Rarely (Less than 2%) Balancing Occasionally (3-33%) Stooping Occasionally (3-33%) Kneeling Rarely (Less than 2%) Crouching Rarely (Less than 2%) Crawling Rarely (Less than 2%) Reaching Occasionally (3-33%) Gross Manipulation (Handling) Constantly (67-100%) Fine Manipulation (Fingering) Frequently (34-66%) Feeling Constantly (67-100%) Foot Use Rarely (Less than 2%) Vision - Far Constantly (67-100%) Vision - Near Constantly (67-100%) Talking Constantly (67-100%) Hearing Constantly (67-100%)

Remote Type

Hybrid

Work Location

81 Highland Avenue

Scheduled Weekly Hours

40

Employee Type

Regular

Work Shift

Day (United States of America)

Pay Range

$30.60 - $44.51/Hourly

Grade

6At Mass General Brigham, we believe in recognizing and rewarding the unique value each team member brings to our organization. Our approach to determining base pay is comprehensive, and any offer extended will take into account your skills, relevant experience if applicable, education, certifications and other essential factors. The base pay information provided offers an estimate based on the minimum job qualifications; however, it does not encompass all elements contributing to your total compensation package. In addition to competitive base pay, we offer comprehensive benefits, career advancement opportunities, differentials, premiums and bonuses as applicable and recognition programs designed to celebrate your contributions and support your professional growth. We invite you to apply, and our Talent Acquisition team will provide an overview of your potential compensation and benefits package.

EEO Statement:

3200 North Shore Medical Center, Inc. is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. To ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veteran’s Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact Human Resources at View phone number on aiapply.co.

Mass General Brigham Competency Framework

At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline.