Training, Quality, and Audit Specialist - PreArrival - Full Time 8 Hour Days (Exempt) (Non-Union)
$68.64k - $112.37kUniversity of Southern California
The Training and Quality Audit Specialist is responsible for developing, coordinating and conducting continued education, quality assurance, and staff development across the organization. This individual is responsible for the provision of orientation and ongoing education to Revenue Cycle staff responsible for registration, insurance verification, securing authorization and calculating, communicating and collecting patient liability. The Specialist is to provide or share training materials (documents, PowerPoint educational tools, etc.) with all facilities and ancillary departments. Other primary responsibilities include identifying and reporting on quality trends, identifying root causes, providing process improvements, and recommending staff education and training. The Specialist is responsible for developing curriculum and providing education on regulatory, system and operational changes. Essential Duties Maintain a high-performance work environment characterized by positive relationships and a strong orientation to quality work and patient care. Assist with the development and implementation of policies and procedures that guide, assess, and improve work group effectiveness, and ensure orientation core competencies to departmental staff. Evaluate accounts for quality measurement using denial reports and random sampling to ensure department and staff quality goals are met. Assist in developing and maintaining weekly/monthly reports to leadership. Responsible for reporting key quality indicators to Revenue Cycle leadership. Design, develop and disseminate training manuals (i.e. Insurance verification/benefits/LOA/non-contracted process) and reference material for Revenue Cycle staff education. Develop targeted education to improve opportunities identified in the quality audits and denial management reports using a variety of education modalities. Complete an analysis and recommend action needed regarding new insurance and related rules, changes in regulatory requirements as well as software enhancements. Ensure all training provided is consistent with Federal and State regulation, policies, and accreditation of compliance requirements. Provide one on one education with individuals who have multiple billing edit errors to ensure an accurate and standard process. Provide on the job training to mitigate high turnover/new employee knowledge gaps. Develop annual competency tests staff must pass as part of the annual evaluation (i.e. Insurance verification/benefit, ABN, Scripting for POS cash, COA, patient rights, IM, and other regulatory documents, etc.). Perform all duties as assigned. Required Qualifications High school or equivalent.
- year experience in a hospital environment.
- years experience as a Revenue Cycle trainer.
$25 - $39.69 per hour
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