RCM Quality Assurance Specialist

Raventra Health is a medical services company providing outsourced billing, coding, and claims processing solutions for provider groups and hospitals. As an RCM Quality Assurance Specialist, you will review revenue cycle work for accuracy, consistency, and compliance with established processes and client requirements. You will identify errors and recurring issues, provide actionable feedback, and help improve the quality and reliability of Raventra Health’s billing, coding, and claims operations.

• Conduct quality reviews of billing, coding, claims, payment posting, and other revenue cycle activities

• Review work samples for accuracy, completeness, and compliance with established procedures

• Identify errors, process gaps, and recurring quality issues and document findings

• Track quality results and identify trends across teams, workflows, and client accounts

• Provide clear and constructive feedback to team members and operational managers

• Collaborate with billing, coding, claims, and AR teams to address root causes of recurring errors

• Support the development and maintenance of quality standards, checklists, and review procedures

• Assist with internal audits and client quality reviews when required

• Prepare quality reports and communicate findings and recommendations to relevant stakeholders

• 2+ years of experience in healthcare revenue cycle, medical billing, coding, claims, quality assurance, or a related healthcare operations role

• Strong understanding of healthcare revenue cycle processes and billing workflows

• Experience reviewing work for accuracy, completeness, and compliance

• Strong attention to detail and ability to identify both individual errors and broader process issues

• Analytical skills with the ability to identify trends and determine root causes

• Strong written and verbal communication skills

• Ability to provide constructive feedback and work collaboratively with operational teams

• Strong organizational skills and ability to manage multiple quality reviews and deadlines

• Ability to work independently and effectively in a fully remote environment

• HIPAA-compliant private workspace

• Medical billing or coding certification such as CPC, CCS, or CPB

• Experience with quality assurance or auditing in healthcare RCM

• Experience with Epic, Athena, eClinicalWorks, or another major healthcare system

• Experience developing quality metrics, audit reports, or performance dashboards

• Experience working with provider groups or hospitals

Compensation will be discussed during the interview and will reflect the candidate’s experience, qualifications, certifications, and relevant healthcare revenue cycle expertise.

Benefits and additional employment details will be discussed during the hiring process.

Application review → introductory conversation → hiring manager interview → offer.

Raventra Health is an equal opportunity employer. We consider all qualified applicants without regard to race, colour, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected characteristic. If you need an accommodation at any stage of the hiring process, please contact us and we will work with you to provide appropriate support.

Location: Remote