Quality Assurance Team Lead

Description/Job Summary

POSITION SUMMARY: The Quality Assurance Team Lead proactively leads the design of reliable Revenue Cycle Management (RCM) processes that produce a result free from defects. The QA Lead also coordinates Quality Control monitoring of billing, payer enrollment, cash application and collection activity regarding adherence to procedures and policies as determined by RCM and Arkana.

ESSENTIAL FUNCTIONS

Reasonable Accommodations Statement

To accomplish this job successfully, an individual must be able to perform, with or without reasonable accommodation, each essential function satisfactorily. Reasonable accommodation may be made to help enable qualified individuals with disabilities to perform the essential functions.

Essential Functions Statement(s)

Proactively works with Billing Team Lead to continuously improve the medical billing process to produce a consistent, quality product free from defects

Develops and regularly generates quality-focused reporting with a goal to improve RCM KPIs that support an improved RCM Clean Claim Rate

Completes monthly Quality Assurance Committee Report

Administers equitable allocation of denial-work to the QA team

Supports team in resolving denial questions and issues

Regularly communicates resolution of claim denials to Billing Team Lead to continuously improve the billing process

Researches and communicates to Billing Team Lead payer policy guideline changes

Develops strategy around Provider Enrollment and oversees its execution through supervision through the Credentialling Specialist

Determines the accuracy and legitimacy of all insurance refund requests

Proactively works with Accounts Receiving Team Lead to continuously improve the remittance posting process to produce a consistent, quality product free from defects

Collaborate with Revenue Cycle Manager and key stakeholders to develop action plans for addressing performance gaps and achieving targets

Recommend and implement best practices to streamline revenue cycle operations, reduce denials, and improve collections

Qualifications

Five years of medical billing experience

Proficient with various software applications (Outlook, Excel, Word), computer systems, web-based applications, and third-party portals

Skills and Abilities

Proven track record of process improvement to drive accuracy and efficiency

Evidenced problem-solver

Strong leadership skills

Excellent verbal and written communication skills

Detail-oriented and analytical thinker

Demonstrated ability to project manage (i.e. scheduling, critical thinking, communication)

Company Benefits

Specifically, we offer the following benefits to full-time employees:

• Competitive salary
• Generous paid time off
• Minimal cost health insurance for you and affordable options for your family
• 401(k) with immediate eligibility and match
• Company-paid life insurance
• Company-paid long term disability coverage
• Affordable vision and dental plans
• Flexible Spending Account or Health Savings Account availability
• Wellness plan
• Monthly in-office massages and employer-sponsored lunches

Please see Careers for further information.