Under general direction of the Quality Manager, responsible for implementing new quality procedures and monitoring ongoing quality initiatives in support and success of the operations program. PRIMARY DUTIES AND RESPONSIBILITIES:
- Performs quality audits on patient files to determine if information was processed according to standard operating procedures.
- Analyzes quality audit results in order to assess future training needs for the team; provides feedback to management team on standard operating procedures and updates as needed.
- Leads ongoing quality training sessions in order to reduce quality issues on the team.
- Assists with and monitors Fax quality Review Process.
- Assists with creating new quality metrics.
- Assists with regional payer surveillance activities.
- Provides dedicated support to an assigned subteam.
- Performs related duties as assigned.
Qualifications: EXPERIENCE AND EDUCATIONAL REQUIREMENTS:
Requires broad training in fields such as business administration, accountancy, sales, marketing, computer sciences or similar vocations generally obtained through completion of a four year Bachelors's degree program or equivalent combination of experience and education. High school diploma or GED minimally required. Normally requires two (2) years reimbursement, billing, coding, and/or project based research experience working as a reimbursement counselor.
MINIMUM SKILLS, KNOWLEDGE AND ABILITY REQUIREMENTS:
- Firm understanding of reimbursement, patient assistance programs and benefit verifications
- Ability to lead and develop training sessions that address quality issues
- Must be self motivated with strong positive attitude
- Strong attention to detail; highly accountable
- Ability to take direction, work independently
- Must have excellent time management skills
- Excellent communication skills; ability to communicate effectively both orally and in writing
- Strong interpersonal skills
- Good problem solving skills and ability to prioritize
- Good analytical skills; desire to further develop analytic skills