Claims Follow-up Trainer/Auditor

Brown University Health; Town of Providence (NY); Hybrid; USD 30,000 - 50,000; Full time

Job summary

Brown University Health is seeking a Claims Follow-up Trainer/Auditor to develop and sustain training programs for the claims follow-up team in Providence, RI. The role focuses on onboarding, staff development, and on-the-job training across all follow-up functions, including Epic navigation and PFS policies.

The position requires auditing of staff performance, creating training materials, and using data to target improvement opportunities while upholding the organization’s values and success

Qualifications

• A four-year college education or equivalent hospital experience.
• Strong verbal and written communication skills.
• Computer skills and knowledge of 3rd party billing including ICD-10, CPT-4, UB04, HCFA 1505.
• Understanding of general accounting.

Responsibilities

• Develops, organizes, and implements a claims follow-up training program across all claims follow-up functions.
• Plans, coordinates, and leads internal in-services and educational training, including Epic navigation and PFS policies.
• Creates training tools such as manuals, presentations, and tip sheets.
• Trains staff in using systems and e-learning platforms.
• Performs day-to-day auditing of the quality of Follow-Up staff actions to resolve accounts efficiently.
• Provides one-on-one targeted training to address performance deficiencies.
• Analyzes trends in performance data to adjust training programs as needed.
• Maintains quality assurance and safety policy adherence.
• Performs other related duties.

Skills

Verbal and written communication

Computer skills

3rd party billing knowledge

Education

Four years college or equivalent hospital experience

Tools

Epic system navigation

Job description

SUMMARY:

Under general supervision of the Claims Follow-up Manager, the Claims Follow-up Traineruditor is responsible for operationalizing and maintaining successful education programs. In addition to planning and leading training initiatives, this individual's responsibilities include continuously monitoring quality and performance metrics and using this data to identify and develop targeted opportunities for staff development in all areas. The Claims Follow-up Traineruditor will also be responsible for creating and maintaining policies and procedures for the department.

Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.

In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:Instill Trust and Value DifferencesPatient and Community Focus and Collaborate

RESPONSIBILITIES:

Develops, organizes, and upon approval, implements a claims follow-up training program for new hire orientation, staff development, and on-the-job training across all claims follow-up functions.Plans, coordinates, and leads internal in-services and educational training for all claims follow-up staff functions including claims follow-up functions, Epic system navigation, and PFS policies and procedures.Develops in-depth knowledge of educational resources and determines how resources can best support training initiatives.Creates training tools including, but not limited to: manuals, presentations, and tip sheets.Trains staff in utilizing systems and/or applications applicable to their job duties as well as e-learning technology and web-based educational offerings.Performs day-to day auditing of the quality of Follow-Up staff's actions on patient accounts to ensure all proper actions are taken to resolve account balances in the most expeditious manner.Provides one-on-one targeted training in response to performance deficiencies, and promotes a collaborative environment by addressing issues in a constructive and proactive manner.Analyzes trends in organizational and individual performance data and uses information to adjust and refine training programs as needed.Maintains quality assurance, safety, environmental and infection control in accordance with established policies, procedures, and objectives of the system and affiliates.Performs other related duties as required.

WORK LOCATIONS/EXPECTIONS:

After orientation at the Corporate facilities, work is performed based on the following options approved by management and with adherence to a signed telecommuting work agreement and Patient Financial Services Remote Access Policy and Procedure.Full time schedule worked in officeFull time schedule worked in a dedicated space in the homePart time schedule in office and in a dedicated space within the homeSchedules must be approved in advance by management who will allow for flexibility that does not interfere with the ability to accomplish all job functions within the said schedule. Staff are required to participate in scheduled meetings and be available to management throughout their scheduled hours. Staff must be signed into Microsoft Teams during their entire shift and communicate with Supervisor as directed.

MINIMUM QUALIFICATIONS:

BASIC KNOWLEDGE:

A level of knowledge generally obtained through four years college or equivalent hospital experience.Good verbal and written communication skills.Computer skills.Extensive knowledge of 3rd party billing for all payers to include ICD-10, CPT-4 coding, UB04, and HCFA 1505 claim form, and keyboarding.Understanding of general accounting.

EXPERIENCE:

Five years related experience.

INDEPENDENT ACTION:

Performs independently within administrative policies and practices and the scope of the affiliate organization.

WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:

Working conditions are generally good requiring interaction with all levels of departmental staff and management. Requires objective monitoring and vigilance in regard to operational aspects that do or may affect revenues.

SUPERVISORY RESPONSIBILITY:

None

Pay Range:

$22.04-$36.37

EEO Statement:

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

Location:

Corporate Headquarters - 15 LaSalle Square Providence, Rhode Island 02903

Work Type:

M-F 8:00am-5:00pm

Work Shift:

Day

Daily Hours:

8 hours

Driving Required:

No