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Supervisor, Pre-Claim QA

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Ventra Health

9d ago

  • Job
    Full-time
    Senior Level
  • People, HR & Administration
    Healthcare
  • Chennai

AI generated summary

  • You need a bachelor's degree, 6+ years in healthcare revenue cycle management, leadership skills, attention to detail, data analysis proficiency, and knowledge of healthcare regulations and billing systems.
  • You will lead a QA team, implement quality processes, monitor performance, resolve issues, train staff, ensure compliance, and collaborate with departments to enhance charge entry efficiency.

Requirements

  • - Bachelor's degree in any related field.
  • - A minimum of 6 years of experience in healthcare revenue cycle management, with a focus on specifically in demo entry, charge entry, or related areas, is typically required. Supervisory or leadership experience is preferred.
  • - Strong leadership, management, and team-building skills with the ability to motivate, empower, and develop team members.
  • - Exceptional attention to detail and accuracy to identify and rectify discrepancies in demo and charge entry records.
  • - Proficiency in data analysis, problem-solving, and critical thinking to identify root causes of issues and implement effective solutions.
  • - Excellent verbal and written communication skills to effectively communicate with team members, management, stakeholders, and external parties.
  • - Familiarity with healthcare billing systems, electronic health records (EHR), revenue cycle management software, and Microsoft Office applications.
  • - Understanding of healthcare regulations such as HIPAA, Medicare, Medicaid, and third-party payer policies related to demo and charge entry.
  • - Ability to adapt to changing priorities, handle pressure, and work effectively in a fast-paced environment with tight deadlines.

Responsibilities

  • Supervision and Leadership: Provide leadership, guidance, and support to a team of quality assurance specialists responsible for demo and charge entry processes.
  • Quality Assurance Management: Develop, implement, and maintain quality assurance processes and procedures to ensure accurate and timely entry of demographic information and charges into the healthcare organization's systems, including electronic health records (EHR) and billing software.
  • Training and Development: Train, mentor, and coach team members to ensure they possess the necessary skills and knowledge to perform demo and charge entry duties accurately and efficiently.
  • Performance Monitoring and Evaluation: Monitor team performance metrics, conduct regular performance evaluations, and provide feedback to drive continuous improvement and meet productivity targets.
  • Issue Resolution and Escalation: Address and resolve any discrepancies, errors, or issues related to demo and charge entry promptly and effectively. Escalate complex issues to appropriate stakeholders for resolution as needed.
  • Collaboration and Communication: Collaborate with other departments such as billing, coding, clinical operations, and finance to streamline processes, resolve issues, and improve overall revenue cycle management efficiency. Communicate effectively with team members, management, and stakeholders to ensure alignment with organizational goals and objectives.
  • Compliance and Regulatory Adherence: Ensure compliance with relevant healthcare regulations, billing guidelines, payer policies, and industry standards governing demo and charge entry activities.
  • Documentation and Reporting: Maintain accurate records, documentation, and audit trails of demo and charge entry activities. Generate reports, analyze data, and identify trends to support decision-making and process improvement initiatives.

FAQs

What is the main responsibility of the Supervisor, Pre-Claim QA?

The main responsibility is to oversee a team responsible for maintaining the accuracy and efficiency of demographic data entry and charge entry processes within the healthcare organization's revenue cycle management.

What qualifications are required for the Supervisor, Pre-Claim QA position?

A Bachelor's degree in a related field and a minimum of 6 years of experience in healthcare revenue cycle management, with a focus on demo entry, charge entry, or related areas, are typically required. Supervisory or leadership experience is preferred.

What skills are important for this role?

Important skills include exceptional attention to detail, proficiency in data analysis and problem-solving, excellent verbal and written communication, familiarity with healthcare billing systems and EHR, and a solid understanding of healthcare regulations such as HIPAA and Medicare.

What does the training and development aspect entail in this position?

The training and development aspect involves training, mentoring, and coaching team members to ensure they possess the necessary skills and knowledge to perform demo and charge entry duties accurately and efficiently.

How does this role contribute to compliance and regulatory adherence?

The role involves ensuring compliance with relevant healthcare regulations, billing guidelines, payer policies, and industry standards governing demo and charge entry activities.

What collaboration is expected from the Supervisor, Pre-Claim QA?

Collaboration with other departments such as billing, coding, clinical operations, and finance is expected to streamline processes, resolve issues, and improve overall revenue cycle management efficiency.

What is involved in the performance monitoring and evaluation tasks for this role?

This involves monitoring team performance metrics, conducting regular performance evaluations, providing feedback, and driving continuous improvement to meet productivity targets.

Are there opportunities for growth within this position?

Yes, through leadership, mentoring, and the continuous improvement of team processes, there are ample opportunities for personal and professional growth.

What is the company culture like at Ventra Health?

Ventra Health is committed to fostering a culturally diverse organization, promoting inclusiveness, mutual respect, and encouraging applications from a diverse pool of candidates.

How can candidates verify the legitimacy of a job offer from Ventra Health?

Candidates can verify the legitimacy of a job offer by contacting Ventra Health directly through official channels, such as emailing Careers@VentraHealth.com. All legitimate roles are posted on their official careers page.

Ventra Health

A Healthcare Revenue Cycle Management Company.

Science & Healthcare
Industry
1001-5000
Employees
2021
Founded Year

Mission & Purpose

Ventra Health is a healthcare revenue cycle management company that specialises in providing services and solutions to enhance the financial performance of healthcare providers. They streamline processes such as medical billing, coding, and claims management to ensure that healthcare organisations are optimising their revenue and improving efficiency. Ventra Health's ultimate mission is to empower healthcare providers to focus on patient care by handling the complexities of revenue management. Their purpose is to simplify the financial side of healthcare, ensuring accurate reimbursements and improving the overall financial health of their clients