Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, and now radiology, through the recent combining of forces with Advocate RCM. Focused on Revenue Cycle Management and Advisory services, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities. Job Summary The Physician Quality Assurance (QA) Specialist is responsible for ensuring the accuracy and consistency of physician names on all billing documents and claims submissions. This role involves meticulous review and validation of physician names to prevent errors, discrepancies, and potential compliance issues. The QA Specialist collaborates with billing staff, healthcare providers, and coding professionals to maintain high standards of data integrity and compliance with regulatory requirements. Essential Functions And Tasks Review and validate physician names on billing documents, including encounter forms, superbills, claims, and electronic health records (EHR). Verify that physician names are accurately spelled and consistently formatted according to established guidelines and standards. Identify and rectify discrepancies or variations in physician names to ensure accuracy and consistency across billing systems and documentation. Collaborate with billing and coding teams to address issues related to incorrect or incomplete physician names on billing documents. Conduct regular audits and quality checks to monitor compliance with physician name standards and identify opportunities for improvement. Provide guidance and training to billing staff on proper procedures for capturing and documenting physician names in billing records. Stay informed about changes in regulatory requirements and industry standards related to physician name documentation in healthcare billing. Document findings, recommendations, and actions taken to address physician name-related issues and maintain audit trail for compliance purposes. Education And Experience Requirements Strong attention to detail and accuracy in data verification and validation. Knowledge of medical terminology and familiarity with physician naming conventions. Understanding of healthcare billing processes, including encounter coding and claims submission. Experience in quality assurance, medical billing, or healthcare administration preferred. Proficiency in using billing software, electronic health records (EHR), and other healthcare information systems. Knowledge, Skills, And Abilities Excellent communication and interpersonal skills for collaborating with multidisciplinary teams. Ability to work independently and prioritize tasks effectively in a fast-paced environment. Commitment to upholding confidentiality and privacy standards in handling sensitive healthcare information. Other IND2
