Job Responsibilities
- Take charge of leading and managing the quality team by providing essential guidance, training, and performance assessments.
- Make sure that the team follows all company policies and procedures.
- Encourage team members to reach their individual and team performance objectives.
- Oversee daily audits to ensure compliance with federal, state, and payer‑specific requirements, including CMS regulations, ICD‑10 coding standards, and DRG‑based reimbursement methodologies.
- Prepare detailed reports on findings from audits and data reviews, including identifying patterns of errors, and areas of concern.
- Assist in the implementation of corrective actions and quality improvement initiatives to optimize revenue cycle performance and improve the accuracy of the projects.
- Build and maintain positive relationships with clients, insurance companies, and other stakeholders.
- Strive for high levels of client satisfaction through effective communication and problem‑solving.
- Ensure compliance with healthcare regulations, company policies, and industry standards.
- Prepare and deliver regular performance reports to senior management.
Required Qualifications
- A degree in any discipline is required.
- A year of hands‑on people manager experience in accounts receivable quality in the U.S. healthcare field.
- Comprehensive knowledge of accounts receivable procedures and billing practices in healthcare.
- Well‑versed in the insurance claim submission and reimbursement processes for Medicare, Medicaid, and commercial insurance.
- Familiar with electronic medical records (EMR) and billing systems like Epic, Cerner, and Meditech.
Preferred Qualifications
- Outstanding analytical and problem‑solving skills.
- Skilled at prioritizing and managing multiple tasks in a busy environment.
- Proficient in Microsoft Office Suite, including Excel, Word, and Outlook.
- Excellent communication and interpersonal skills, both written and verbal.
- Willing to work in a round‑the‑clock environment.
Benefits
- Term life, accidental & medical insurance.
- Meal and transport arrangements.
Core Values and Expectations
- Demonstrate integrity and ethics in day‑to‑day tasks and decision‑making, adhere to FinThrive’s core values of being Customer‑Centric, Agile, Reliable, and Engaged, operate effectively in the FinThrive environment and the environment of the workgroup, maintain a focus on self‑development and seek out continuous feedback and learning opportunities.
- Support FinThrive’s Compliance Program by adhering to policies and procedures about HIPAA, GLBA, FCRA, and other laws applicable to FinThrive’s business practices; become familiar with FinThrive’s Code of Ethics, attend training as required, notify management or FinThrive’s Helpline when there is a compliance concern or incident, HIPAA‑compliant handling of patient information, and demonstrable awareness of confidentiality obligations.
FinThrive is an Equal Opportunity Employer and ensures its employment decisions comply with principles embodied in Title VII, the Age Discrimination in Employment Act, the Rehabilitation Act of 1973, the Vietnam Veterans Readjustment Assistance Act of 1974, Executive Order 11246, Revised Order Number 4, and applicable state regulations.