Program Manager, Quality Assurance-Accounts Receivable
Under direction of the Senior Manager, Accounts Receivable Operations, the Program Manager of Quality Assurance will be responsible for the development and maintenance of the quality program for the Accounts Receivable department. This includes the initial and ongoing training of Accounts Receivable Specialists within Revenue Cycle Operations. This role also involves maintaining the quality program by which the Accounts Receivable follow-up work will be evaluated for opportunities and enhancement. Ultimately, the QAC provides and supports the infrastructure necessary to ensure that the training and performance improvement needs of the AR Specialists are met. The AR Quality Assurance Coordinator reports to the Senior Manager of Accounts Receivable Operations.
Overall quality program ownership and management with a focus on:
- Initial development along with ongoing evaluation and maintenance of a quality program including scoring measurements and rebuttal process.
- Perform routine audits of accounts worked by Accounts Receivable Specialists to assess diligence and urgency, and report findings to AR Leadership.
- Effectively communicate audit results to individual Accounts Receivable Specialists, and provide necessary coaching and re-training.
- Conduct quarterly competency assessments for Accounts Receivable Specialists.
- Assist and support Team Leads and AR Managers with performance improvement initiatives.
Lead and direct the AR Department New Hire Training sessions and department competency standards including:
- Responsible for training Accounts Receivable Specialists on athenaNet and other relevant applications and systems related to third party claims billing and follow-up.
- Training responsibilities will also include applicable Steward Medical Group policies and procedures and Accounts Receivable workflows.
- Identify and initiate additional training needs or enhancements, in partnership with AR Management.
- Maintain professional competency, according to department policies, procedures and protocols.
- Maintain a repository of knowledge required to train new revenue cycle associates including manuals, tip sheets and other materials.
- Maintain strict confidentiality and adhere to all HIPAA guidelines/regulations.
- 3 years minimum experience in physician billing and AR follow-up, within a highly productive environment.
- Demonstrated ability to effectively train others in a work environment.
- Experience with patient accounting systems, billing/claim submission software required. AthenaNet experience required.
- Knowledge and understanding of industry best practices, relative to billing and claims follow-up procedures.
- Ability to analyze claims worked and assess the level of quality based on defined performance standards.
- Possess ability to work efficiently and accurately, and to organize and plan work.
- Possess flexibility and adaptability to work additional hours and to work under stress.
- Ability to establish and maintain effective working relationships and communicate clearly with customers both within and outside of Steward.
- Highly detail oriented and well organized; ability to multitask.
- Education: Associate’s or Bachelor’s Degree preferred, or commensurate years of experience.
- Experience (Type & Length): At least 3 years’ related experience, 5 years if no degree.
- Software/Hardware: AthenaNet required (certification a plus), MS Office suite required.
Steward Health Care is the largest private, for-profit health care network in the United States. The company is owned and led by a management team of Steward physicians. Headquartered in Dallas, Texas, Steward employs more than 40,000 health care professionals and operates 35 hospitals across the United States and in the countries of Malta and Colombia which regularly receive top awards for quality and safety. The Steward network includes multiple urgent care centers and skilled nursing facilities, substantial behavioral health services, more than 7,000 beds under management, and approximately 2.2 million full risk covered lives through the company's managed care and health insurance services.
The Steward Health Care Network includes more than 5,000 physicians across 800 communities who help to provide more than 12 million patient encounters annually. Steward Medical Group, the company's employed physician group, provides more than six million patient encounters per year. The Steward Hospital Group operates hospitals in Malta, Colombia and nine states across the U.S., including Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, Texas, and Utah. For more information, visit www.steward.org.
Steward Health Care is an Equal Employment Opportunity (EEO) employer, Steward Health Care does not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, and or expression or any other non-job-related characteristic.
Steward Medical Group is taking additional necessary preparations to ensure patients can receive compassionate care in safe, carefully managed environment – with confidence and without fear.
Our Safe and Ready program consists of a rigorous [three-point] standard ensuring patient safety, confidence and convenience.
- Any COVID-19 related care takes place in designated areas away from other patients and their families.
- A stringent cleaning policy has been implemented throughout our facilities.
- A strictly controlled visitor and mask policy is required for patient and colleague safety.