QA & Training Manager - Behavioral Health

Medusind is a leading provider of revenue cycle management solutions 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 Medusind to continue to advance its leadership position as one of the top revenue cycle management companies in the country.

Position Overview

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.

Job Details: Full-time, fully remote, 60-62k Annually.

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.)
  
  

About Medusind

Since 2002, organizations across the entire healthcare spectrum have leveraged our deep expertise and high-quality solutions to maximize revenue, reduce operating costs and navigate the changing healthcare landscape.Medusind’s unique combination of deep industry expertise, robust operational capability, and client-focused service significantly improves the efficiency and profitability of healthcare organizations. Client satisfaction is the primary focus of the Medusind leadership and staff.Our highly experienced personnel, cutting edge technology, and forward thinking approach allows us to deliver effective solutions while staying ahead of healthcare industry changes.