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Luminis Health · 4 hours ago

Quality Assurance Trainer - PAVE

Annapolis, MD

Full-time

Onsite

Mid, Senior Level

$29/hr - $37/hr

5+ years exp

Luminis Health is seeking a Quality Assurance Trainer for their PAVE department. The role involves assessing, planning, developing, and implementing educational needs for staff, while also participating in quality improvement initiatives and ensuring compliance with health care industry changes.

Health CareMedicalNon Profit

Responsibilities

Design and maintain new hire PAVE training materials

Conduct new hire registration training biweekly

Evaluates and supports new hires for a minimum of six months

Works with department leaders to develop Performance Improvement Plans, when necessary

Using Epic scorecard functionality, reviews quality of accounts insurance and authorization for all PAVE staff, identifying areas of opportunity for re-training, new education, or workflow re-design

Identifies and develops competencies for staff, holding in-service training sessions as needed Reports on issues with registration performance to department leaders

Identifies denial trends that may be positively impacted by registration education and implements training

Responsible for understanding the complexities of health insurance plans and the relationship between health plans (Medicare, Medicaid, Commercial Insurance, Blue Cross, Worker’s Compensation, MVA coverages, and self-pay

Assists with the completion of accounts by obtaining authorizations, verification of insurance eligibility and benefits

Develop competency assessments for all PAVE training and are responsible for conducting/overseeing training, post-class assessments, record keeping and communication of end-user completion of training

Respond to training issues or needs when identified by end-users and leadership. PAVE training may be virtual, classroom based and/or unit/department based, and includes one-on-one training, remedial training, and on-call training support to assist end-users

Performs quality assurance testing and work queue monitoring to assist in developing training needs as well as shadowing all PAVE positions

Responsible for the creation and standardization of educational materials

Performs other duties as assigned by PAVE Leadership

Qualification

Medical BillingRevenue Cycle ExperienceEpic Hospital Billing SystemAnalytical SkillsHealthcare CertificationMicrosoft OfficeInsurance TerminologyTraining DevelopmentQuality Assurance TestingCommunication Skills

Required

Minimum five (5+) years of experience in Medical Billing, Hospital Patient Access, or Hospital Business Office in an automated setting

Knowledge of registration, verification, pre-certification, and scheduling procedures

Experience with Medical and Insurance terminology (ICD-10, CPT 4)

Minimum of three (3+) year of demonstrated strong analytical skills

Proficiency with Microsoft Office and Outlook required

Excellent verbal and written communication skills

Associates Degree Accounting, Finance, Business Administration or Healthcare related field; required

Minimum seven (7+) years of Revenue Cycle Experience in lieu of degree

One (1+) or more certifications from AAHAM, NAHAM or HFMA preferred or obtained within 6 months

Healthcare Certification

Preferred

Preferred experience with the Epic Hospital Billing System

Bachelor's degree, preferred

1 or more Certifications preferred: CRCE - Certified Revenue Cycle Executive, CRCP- Certified Revenue Cycle Professional, CRCS- Certified Revenue Cycle Specialist, CHAM – Certified Healthcare Access Manager, CHAA- Certified Healthcare Access Associate, CHFP- Certified Healthcare Financial Professional, CRCR- Certified Revenue Cycle Representative