Supervisor, Accounts Receivable QA

About Us:

- Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, and now radiology, through the recent combining of forces with Advocate RCM. Focused on Revenue Cycle Management and Advisory services, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

Job Summary:

- We are seeking a motivated and experienced individual to join our team as the Healthcare Supervisor, Accounts Receivable (AR) Quality Assurance. In this role, you will be responsible for leading our AR quality assurance team, overseeing the accuracy and efficiency of accounts receivable processes, and ensuring compliance with healthcare regulations and billing guidelines. Your primary focus will be on supervising the AR quality assurance staff, conducting audits, providing training and feedback, and implementing quality improvement initiatives to optimize revenue performance.

Essential Functions and Tasks:

- Lead and supervise a team of Healthcare Accounts Receivable (AR) Quality Assurance Specialists, providing guidance, training, and support to ensure the accuracy and efficiency of accounts receivable processes.
- Conduct regular audits and reviews of healthcare accounts receivable activities to identify billing errors, coding discrepancies, and other issues impacting revenue performance.
- Analyze denials, rejections, and unpaid claims to determine root causes, develop corrective action plans, and monitor progress towards resolution.
- Collaborate with billing specialists, coding staff, and other stakeholders to address billing and coding discrepancies, coding edits, and claim rejections.
- Provide coaching, feedback, and performance evaluations to AR quality assurance staff to promote continuous improvement and adherence to quality standards.
- Develop and implement quality assurance processes, policies, and procedures to improve accuracy, efficiency, and compliance within the accounts receivable function.
- Monitor key performance indicators (KPIs) related to accounts receivable, such as days in accounts receivable (AR), denial rates, and collections, and implement strategies to achieve performance targets.
- Stay informed about changes in healthcare regulations, payer policies, and reimbursement guidelines affecting accounts receivable operations.
- Generate reports and metrics to track accounts receivable performance, identify trends, and measure the effectiveness of quality assurance initiatives.
- Participate in revenue cycle improvement initiatives, process optimization projects, and system upgrades as needed.

Education and Experience Requirements:

- Bachelor's degree in any related field.
- Minimum of 6 years of experience in healthcare revenue cycle management, with a focus on accounts receivable and billing.
- Strong understanding of medical coding, billing, and reimbursement processes, including knowledge of CPT, ICD-10, and HCPCS coding systems.

Knowledge, Skills, and Abilities:

- Proven leadership and supervisory experience, with the ability to effectively coach, mentor, and develop a team.
- Knowledge of healthcare regulations, payer guidelines, and compliance requirements related to accounts receivable.
- Excellent analytical skills and attention to detail.
- Strong communication and interpersonal skills, with the ability to collaborate effectively with cross-functional teams.
- Experience with auditing, quality assurance, and performance improvement initiatives.
- Proficiency in using billing software, electronic health records (EHR) systems, and revenue cycle management tools.

Ventra Health:
**Equal Employment Opportunity (Applicable only in the US)**

**Recruitment Agencies**

Ventra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.

**Solicitation of Payment**

Please be aware that there have been reports of individuals falsely claiming to represent Ventra Health or one of our affiliated entities Ventra Health Private Limited and Ventra Health Global Services. These scammers may attempt to conduct fake interviews, solicit personal information, and, in some cases, have sent fraudulent offer letters.