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Align yourself with an organization that has a reputation for excellence! Ranked as No. 1 Workplace by Indeed.com, we also were awarded the Advisory Board Company’s Workplace of the Year. This recognizes hospitals and health systems nationwide that have exceptional levels of employee engagement. We offer an outstanding benefit package that includes paid time off, health care and a 403(B) along with competitive compensation. Join us! Discover why U.S. News & World Report has named us one of America’s Best Hospitals.

What will I be doing in this role?

The Payor Revenue Management (PRM) Quality Review & Trainer works under limited supervision and guidelines, within CSHS policies and procedures. In this role, you will develop and track departmental Quality Review (QR) indicators and report findings. Perform independent Quality Reviews of individual performance as needed to supplement supervisory reviews. Analyze findings to identify and offer solutions for new and innovative ways to improve processes within the department. Function as a positive, creative, and effective contributor, actively participating in performance improvement activities and consulting in implementation of education programs. Assess training needs, develop training program and deliver training. Standardize, publish, and maintain Payer Revenue Management policies, procedures and job aids. Respond to regulatory and contractual changes impacting the practices of the department and ensure prompt communication and implementation of appropriate procedures. Act as a technical subject expert in the use of policies, procedures, and systems in support of the Payer Revenue Management goal to achieve maximum patient account collections and minimum accounts receivable days thus directly and specifically contributing to medical center system cash flow. Serve as a resource for Payer Revenue Management leadership and staff regarding processes, procedures, and system fluency The PRM Quality Review & Trainer will:

• Develop quality review indicators for assigned work unit or department.
• Conduct ongoing reviews of staff work performance focused on staff adherence to established policy and expressed account handling expectations.
• Analyze quality review results and provide non-compliance feedback to employees and management, when needed.
• Assist in the identification, prioritization and resolution of issues impacting quality of work product by staff. Perform needs assessment to determine level of training needed by staff.
• Prepare and present management reports on team member training, quality review indicators and outcomes.
• Work in partnership with supervisors and managers in the development of curriculum, including lesson plan, materials, and methods of training to meet the needs of the department.
• Prepare, implement, and conduct training programs that result in a captivating, informative adult learning experience.
• Conduct department training for: new hires, new/revised policy and procedures, compliance, and other subjects as needed.
• Conduct application end-user training for Professional Billing Resolute and other revenue cycle management products as needed. This may relate to new application conversions, major changes in existing application, or refresher courses in existing applications.
• Provide additional training required to correct performance deficiencies, including one-on-one intervention as needed. Monitor improvement after training.
• Maintain and update Payer Revenue Management training modules to ensure appropriate materials are used in staff development.
• Identify processes that should be documented. Create and publish policies, procedures, and job aids on own initiative as need is recognized or at request of PFS Payer Revenue Management Team.
• Monitor adherence to new policy, procedure, or job aid through follow-up audits.
• Function as role model and mentor as well as the "go to" person for staff questions and inquiries.
• Obtain appropriate Epic Professional Billing (PB) certification and participate in CS-Link PB training environment patient build as need arises.

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Requirements:

• High school diploma or GED required. Bachelor’s degree in training, education or another related field preferred.
• Individual should encompass Professional Billing Revenue Cycle experience, specific to 2-3 years of Resolute Professional Billing and workflow experience. Comprehensive revenue cycle workflow understanding acting as a SME supporting professional billing. 
• Epic Resolute Professional Billing Certification preferred.

Why work here?

Beyond outstanding employee benefits including health and dental insurance, vacation, and a 403(b) we take pride in hiring the best, most passionate employees. Our accomplished staff reflects the culturally and ethnically diverse community we serve. They are proof of our commitment to creating a dynamic, inclusive environment that fuels innovation.