Additional Information
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:
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 guides, assesses and improves work group effectiveness, and ensures 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 constant with Federal and State regulation, policies, and accreditation of compliance requirements.
Provide one on one education with individuals will 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:
Req High school or equivalent
Req 1 year Experience in hospital environment.
Req 2 years Experience as a Revenue Cycle trainer.
Req Knowledge of business office procedures.
Req Knowledge of medical terminology and coding.
Req Knowledge of grammar, spelling, and punctuation to type patient information.
Req Ability to read, understand, and follow oral, and written instructions and establish and maintain effective working relationships with patients, employees, and the public.
Req Excellent time management, organizational skills, research/analytical skills, negotiation, communication (written and verbal), and interpersonal skills.
Req Capable of working assigned shifts, overtime when approved.
Req Capable of reading the policy and procedure manual and understanding information pertaining to specific job duties and the general information for all hospital employees.
University Of Southern California · Los Angeles