QA and Training Manager - Behavioral Health

Description:
• Medusind is a leading provider of revenue cycle management solutions to dental, behavioral health, anesthesia, pathology, emergency, surgery, radiology, and other specialties.
• The QA & Training Manager is responsible for companywide quality assurance measures (across all departments), as well as trainings for facilities and internal new hire within all RCM departments.
• The QA functions are standalone, specific to individual departments processes and KPIs.
• Training will be conducted standard for all new facilities and new hires but are also required when QA scoring is below KPI goals, to ensure targets are being met.
• Key Responsibilities: Training & Development: Develop/maintain/manage QA metrics & reporting Develop facility training SOP and process. List details and scope of facility trainings. Develop 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, Healthcare Administration, or related field (preferred).
• Experience: Experience in Behavioral Health RCM, understands SUD/MH levels of care, and overall claims adjudication challenges.
• Understanding of levels of care requirements, ability to work in various systems (excel, word, email) and ability to update trackers.
• Team Leadership: Experience managing a team, setting performance goals, and driving results.
• Expert Industry Knowledge: Strong proficiency in revenue cycle management platforms, workflow tools, and EMR systems.
• Knowledge of HIPAA, Medicare, Medicaid, 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 Carrier 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.)

Benefits:

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