Manager, QA and RCM Training

Summary

Join Rethink Behavioral Health, a leading provider of online behavioral health resources, as a Quality Assurance Manager. You will oversee the quality of Revenue Cycle Management (RCM) services, ensuring compliance and efficiency. Key responsibilities include developing and implementing quality assurance policies, conducting audits, providing staff training, and identifying payor changes. You will also lead and mentor a quality assurance team, fostering a culture of continuous improvement. This role requires extensive experience in quality assurance and RCM, strong leadership skills, and knowledge of relevant regulations. The position offers remote work opportunities in select states and a comprehensive benefits package.

Requirements

• Minimum of 5 years of experience in quality assurance, with at least 2 years in a managerial role within RCM services
• Strong knowledge of quality assurance methodologies, tools, and processes specific to RCM
• Excellent leadership and team management skills
• Strong analytical and problem-solving abilities
• Excellent communication and interpersonal skills
• Knowledge of relevant regulatory requirements and industry standards in RCM

Responsibilities

• Develop and implement quality assurance policies and procedures specific to RCM services
• Monitor and evaluate the effectiveness of quality assurance processes in billing, enrollment, credentialing, and verification of benefits
• Conduct regular audits and inspections to ensure compliance with industry standards and regulations
• Ensure RCM data is accurately reported across the organization weekly
• Assign health risk levels and identify common trends for the team to follow up on through training or by creating additional resources and materials
• Collaborate with RCM teams to identify and resolve quality issues in billing, enrollment, credentialing, and verification of benefits
• Implement continuous improvement initiatives to enhance operational efficiency in RCM processes across all service lines
• Design and deliver training programs to educate staff on quality standards and procedures in RCM services
• Ensure all employees are adequately trained in quality assurance practices related to billing, enrollment, credentialing, and verification of benefits
• Evaluate the effectiveness of training programs and make necessary adjustments
• Create materials and train staff on new products that impact billing services
• Ensure compliance with all relevant laws, regulations, and industry standards related to RCM services
• Stay updated on changes in regulatory/payor requirements and adjust company policies accordingly and disseminate to teams
• Prepare and submit compliance reports to team
• Support client escalations in conjunction with Billing Service Mangers to identify root cause issues to decrease customer churn
• Ensure cohesive and efficient processes for customer invoicing and closing accounts
• Maintain and manage Billing Operations queue for account access needs
• Lead and mentor the quality assurance team within the RCM department
• Foster a culture of quality and continuous improvement within the organization
• Provide regular feedback and performance evaluations to team members
• Perform and oversee a team of people performing the outlined duties

Preferred Qualifications

• Experience in the healthcare industry, specifically in RCM services (Billing, E&C, VOB)
• Experience in billing Quality Assurance
• Experience in Training Curriculum Development
• Experience in Project Management
• Experience in managing a team

Benefits

• PTO and Vacation Days after a 90-day introductory period
• Paid Holidays
• Generous Health, Denial & Vision benefits package
• 401k + Matching
• Remote opportunities are available only in the following states: AL, AR, AZ, CA, CO, FL, GA, ID, IL, IN, IA, MO, NC, NE, NY, OH, PA, SC, TN, TX, UT, VA