Manager, RCM QA & Compliance

Remote
Full Time
Corporate
Manager/Supervisor

 

Help at Home, LLC, is the nation’s leading provider of high-quality care and support solutions. Our goal is to enable the highest level of personal independence and meaningful lives for our clients. Help at Home is committed to delivering a gold standard in care through our attentive and well-trained staff who support making it possible to keep people comfortably and safely within their homes and communities.


Job Summary:

Overall responsibility for the QA & Compliance function within Revenue Cycle Management as well as shared partnership in global company-wide Revenue Cycle Management responsibilities. Directs the activities of an assigned team, resolves moderately complex problems and is accountable for the accuracy and timeliness of data generated by this function. Primary responsibilities include managing and directly overseeing quality assurance function within RCM, lead yearly & ad hoc audits, collaboration with Ethics & Compliance team on payer takebacks, reporting, identifying/implementing necessary controls, coaching employees, and general oversight of all people and processes.

As a People Leader:

  • You lead with empathy, vulnerability, and honesty.
  • Must have a love of learning.
  • Endless curiosity and an enthusiasm for continuous improvement
  • Team-first mindset
  • Empower and inspire full time associates through coaching.
  • Hold others to high standard.
  • Knows how and when to celebrate success.

Supervisory Responsibilities:

  • Directs growing team of RCM Representatives specialized in QA & Compliance.
  • Supervising assigned personnel, mentoring, and coaching to achieve highest level of competency of staff
  • Providing constructive feedback, corrective action plans, reviews, and professional development, when appropriate
  • Conducting staff meetings at regular intervals for informative and educational purposes
  • Incorporate company or departmental changes effectively and timely
  • Ensure departmental goals are met by providing daily guidance to staff to ensure work is done efficiently and timely
  • Identify deficiencies and work to improve them through collaboration within the team and with other departments
  • Manage day to day issues and problems, escalating in a timely manner as necessary
Duties/Responsibilities:
Responsibilities include, but are not limited to:
  • Manage ongoing and implementation of new quality assurance processes
  • Provide QA review of RCM policies and procedures as designated by leadership 
  • Lead yearly and ad hoc revenue cycle management audit requests; obtain and provide documentation to auditors per request
  • Collaborate with corporate Ethics & Compliance team to research and resolve payer takeback requests
  • Manage day to day issues and problems, escalating in a timely manner as necessary
  • Demonstrate ability to work effectively at both granular and big-picture levels
  • Think analytically with the ability to perform root cause analysis, prepare and implement action plans, and lead improvement initiatives
  • Create SOP documentation and process maps, updating with any process changes
  • Partner in the creation, refinement and management of new business lines and/or processes
  • Help drive RCM projects to create efficiencies and streamline processes.
  • Actively contribute to and/or lead company-wide Revenue Cycle Management related activates and visioning
  • Performs other related duties as assigned.

Required Skills/Abilities:

  • Analytic and persistent; able to get to the root of problems.  Self-motivated; reliable; strong attention to details; maintains confidentiality; complies with all policies and procedures. 
  • Demonstrates maturity and the ability to function as a team member, good communication skills. 
  • Able to supervise staff and coach them to improve functioning and overall agency services.  Organized, assertive, mature, approachable and open-minded.  Willing to take initiative.  Identifies and progresses toward meeting personal and professional goals.
  • Able to deal with stress and conflict appropriately.
 

Education and Experience:

  • Bachelor’s degree and/or 5+ years of revenue cycle experience
  • Prior healthcare revenue cycle management/billing experience and knowledge of Home Care service technology, Long Term Care Insurance, Medicaid and Medicare is preferred.
  • Advanced computer skills, including the use of Microsoft Office applications (e.g. Word, Excel). Ability to generate and utilize Microsoft Excel advanced formulas, pivot tables, power queries and advanced charting required.
  • Smartsheet experience is preferred.
 




Benefits:

  • Weekly pay with salary ranges from $80,000- $90,000 annually
  • Direct deposit
  • Healthcare, dental, and vision insurance
  • Paid time off and parental leave
  • 401k
  • Ongoing, in-depth training opportunities
  • Meaningful work with clients who need your help
  • Career growth and experience with an industry leader with 50+years of history in a high-demand field

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions upon request.

Help At Home is an Equal Employment Opportunity (EEO) employer and welcomes all qualified applicants. Applicants will receive fair and impartial consideration without regard to race, sex, color, religion, national origin, age, disability, veteran status, genetic data, or religion or other legally protected status.

Data Security and Privacy Statement

At Help at Home, we prioritize protecting your personal information during the hiring process. We comply with all relevant data privacy regulations, including HIPAA and SOX where applicable. Your data will only be used to assess your employment suitability and won't be shared with unauthorized parties.

We use strong security measures to protect your information from unauthorized access or disclosure. By submitting your application, you consent to this process. You can access, modify, or request deletion of your data by contacting us.

Employees must adhere to our data protection policies and legal requirements to safeguard sensitive information.

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