Key Responsibilities:

 Oversight:

·         Ensure the quality of system improvements and automation initiatives for RCM operations.

·         Completes and monitors systems QA and automation activities to ensure alignment with company standards. Compliance and payer requirements.

System Quality & Automation:

·         Completes and oversees QA testing of internal systems to ensure functionality, accuracy and regulatory compliance.

·         Continually QA automation activities to ensure compliance with NSM requirements and payer standards.

·         Partners with IT and developers to test and implement automation and process improvement projects.

·         Analyze system QA data to identify trends, root causes, and opportunities for improvement in existing systems.

Process & Data Management:

·         Establish, document, and maintain protocols, test plans, and audit records.

·         Prepare and present detailed QA systems reports with actionable insights for leadership review.

·         Monitor automation performance post-deployment and coordinate resolution of system issues.

 Training & Development:

·         Coordinates with training and communication teams to support new system functionality and automation tools.

·         Review findings of QA on new and existing system enhancements and automation with RCM leadership to strengthen process understanding and performance consistency.

·         Foster a culture of continuous improvement, quality awareness and accountability.

 Collaboration & Continuous Improvement:

·         Serve as a liaison between RCM, IT, Compliance, Training, and Operations to ensure cross-departmental alignment.

·         Support development and adherence to policies, procedures and payer regulations.

·         Participate in strategic planning discussions related to technology, quality, and operational excellence.

Work Environment:

This job operates in a professional office environment. This role routinely involves standard office equipment such as computers, phones, printers, photocopiers, filing cabinets, and fax machines.

 Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or listen. The employee is regularly required to sit; use hands repetitively to operate standard office equipment. The employee is frequently required to reach with hands and arms.

Required Education, Experience & Competencies:  

• High School Diploma or G.E.D. Required, College Degree Preferred
• Drug Test
• Knowledge of government payer regulations desired
• Extensive working knowledge of Funding, Billing and Collections for Medicare, Medicaid and Commercial payers
• Good oral, written and communication skills
• Working knowledge of Microsoft suite products
• Proven record of excellent people skills including good communication and inter-personal skills
• Strong Team Player
• Strong organizational skills and attention to detail
• Ability to effectively present information and respond to questions from a variety of staff
• Basic understanding of and willingness to learn and adopt professional and industry business standards/needs.

This job description in no way states or implies that these are the only duties to be performed by this employee. The employee will be required to follow any other instructions and to perform any other duties requested by his/her supervisor.

Individuals will be expected to maintain a professional work environment.