Accounts Receivable QA Specialist

About Us:Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, and now radiology, through the recent combining of forces with Advocate RCM. Focused on Revenue Cycle Management and Advisory services, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.Job Summary:Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, and now radiology, through the recent combining of forces with ADVOCATE RCM. Focused on Revenue Cycle Management and Advisory services, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities. As an AR (Accounts Receivable) Quality Assurance (QA) Specialist, you will play a crucial role in ensuring the accuracy and efficiency of our revenue cycle management processes. You will be responsible for monitoring, evaluating, and providing feedback on the performance of AR Callers to maintain high standards of customer service and compliance with industry regulations.Essential Functions and Tasks:Quality Monitoring:Conduct regular quality monitoring and evaluation of AR Callers" interactions with patients, insurance companies, and other stakeholders.Evaluate adherence to established scripts, procedures, and compliance guidelines.Identify areas for improvement and provide constructive feedback to AR Callers.Performance Analysis:Analyze AR Callers" performance metrics, including call volume, resolution rates, and collection effectiveness.Identify trends, patterns, and opportunities for performance enhancement.Generate reports and insights to support management decision-making.Training and Development:Collaborate with the training department to develop and deliver targeted training programs for AR Callers.Provide coaching and support to improve AR Callers" skills in communication, negotiation, and problem-solving.Conduct refresher training sessions on compliance requirements and best practices.Compliance Assurance:Ensure adherence to regulatory requirements, including HIPAA regulations, Fair Debt Collection Practices Act (FDCPA), and other relevant laws and guidelines.Review and audit documentation to verify accuracy, completeness, and compliance with regulatory standards.Implement corrective actions and process improvements to address compliance issues.Customer Service Excellence:Promote a customer-centric approach among AR Callers, emphasizing empathy, professionalism, and responsiveness in interactions with patients and clients.Monitor customer feedback and satisfaction levels to identify areas for service improvement.Cross-Functional Collaboration:Liaise with other departments, including Billing, Coding, and Customer Service, to resolve complex issues and improve overall revenue cycle performance.Communicate QA findings and recommendations to relevant stakeholders and participate in cross-functional meetings as needed.Education and Experience Requirements:Bachelor's degree or related field (preferred).Minimum 4 years+ proven experience in accounts receivable, revenue cycle management, or healthcare billing.Knowledge, Skills, and Abilities:Strong knowledge of healthcare billing processes, insurance terminology, and revenue cycle workflows.Excellent communication skills, with the ability to provide constructive feedback and communicate effectively with diverse stakeholders.Detail-oriented with strong analytical and problem-solving skills.Proficiency in using MS Office applications and CRM software.Certification in Healthcare Compliance (e.g., CHC) or Quality Assurance (e.g., CQA) is a plus.,
Job Tags
quality assurance, accounts receivable
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