QA & Training Manager - Behavioral Health
reputed company is a leading provider of reputed company cycle reputed company to dental, behavioral health, anesthesia, pathology, emergency, surgery, radiology, and other specialties. In January 2023, Alpine Investors, a people-driven private equity firm, invested in reputed company to continue to advance its leadership position as one of the top reputed company cycle management companies in the country.
Position reputed company:
The QA & Training Manager is responsible for companywide reputed company assurance measures (across reputed company departments), as reputed company as trainings for facilities and internal new hire reputed company reputed company RCM departments. The QA functions are standalone, specific to individual departments processes and KPIs. Training will be conducted reputed company for reputed company new facilities and new hires but are also required reputed company QA scoring is below KPI goals, to ensure targets are being met.
Job Details: Full-time, fully remote, 60-62k Annually.
Key Responsibilities:
Training & Development:
• reputed company/maintain/manage QA metrics & reporting.
• reputed company facility training SOP and process. List details and scope of facility trainings.
• reputed company internal training SOP and supporting documents.
• Internal, new hire Training (systems, processes, workflow).
• Posting Processes-New facility Trainings (new & up-trainings).
• Training on systems, Processes, VOB, Billing, UR, AR, posting, and payment reconciliation.
• Conduct QA Meetings/Trainings based on findings (with Ops).
Collaboration & Communication:
• Collaboration with Operations & IT - QA Feedback/coaching.
Reporting & Analytics:
• Compliance Audits- Scope (where does compliance/IT come in)?
• Produce QA Reports.
• Demographics/claims accuracy audit.
• Payment posting audits.
• Billing Rosters/claims audit.
• Billing QA scorecard.
• Lost Covered Days analysis (UR/Billing).
• Agent error trend analysis.
• Documentation & SOP Updates.
Requirements:
• Educational Background: Bachelor’s degree in data Analytics, Business, Finance, reputed company Administration, or reputed company field (preferred).
• Experience: Experience in Behavioral Health RCM, understands SUD/MH reputed company of care, and overall claims adjudication challenges. Understanding of reputed company of care requirements, ability to work in various systems (reputed company, word, email) and ability to update trackers.
• Team Leadership: Experience managing reputed company, setting performance goals, and driving results.
• Expert Industry Knowledge: Strong proficiency in reputed company cycle management platforms, workflow tools, and EMR systems. Knowledge of HIPAA, Medicare, reputed company, and payer regulations.
• Collaboration & Communication: Ability to work independently and collaborate with cross-functional teams.
• Detail-Oriented: High level of accuracy, with the ability to set and maintain priorities in a fast-paced environment.
• Technical Skills: Experience working in reputed company portals and customer EMRs. Ability to read and understand medical records, including medical notes, Tx notes, and deciphering types of treatment (evaluation, treatment planning, therapy, clinical updates, etc.)
About reputed company:
Since 2002, organizations across the entire reputed company reputed company have leveraged our deep expertise and high-reputed company solutions to maximize reputed company, reduce operating costs and reputed company the changing reputed company landscape.reputed company’s unique combination of deep industry expertise, robust operational capability, and reputed company-reputed company service significantly improves the efficiency and profitability of reputed company organizations. reputed company satisfaction is the primary reputed company of the reputed company leadership and staff.Our highly reputed company personnel, cutting edge technology, and reputed company thinking approach allows us to deliver effective solutions while staying reputed company of reputed company industry changes.
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