Position Objective:
The Quality Assurance & Training Specialist is responsible for the assessment, planning, development, implementation, evaluation and maintenance, monitoring and oversight and training and education needs of staff for the Patient Access and Support Services Team. The Specialist utilizes manual and automated quality assurance reports, denial information and failed claim reports among other tools to develop and distribute quality assurance “Report Cards” for PASS personnel. Serves as a role model for all levels of staff. This position will provide ongoing feedback to managers and staff on performance, quality and process improvement. Provides feedback to the Management Team concerning training needs, quality of work and productivity levels of staff.

Supports and participates in identification and application of appropriate research, in-service, annual competencies, and changes in policies & procedures for the department. The Quality Assurance & Training Specialist advises the Management team of all significant performance issues and recommends discipline when appropriate. To safeguard assets of the hospital by remaining vigilant over changes in the health care industry and monitoring activities of the department to implement changes quickly and efficiently. Assist with account completion to ensure process workflows are current with technology.
Working with the staff and management of the registration, financial counselors and ancillary areas the Quality Assurance Trainer will diligently strive to optimize workflows and establish standardized practices.

Essential Job Duties:

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Design and maintain PASS unit specific training materials and departmental resources for staff and participates in the department’s quality and process improvement plans and initiatives. Responsible for the creation and standardization of educational materials. Conduct new hire departmental training biweekly. Evaluates and supports new hires for a minimum of three months. Works with department leaders to develop Performance Improvement Plans, when necessary.
• Develop competency assessments for all PASS departmental training and are responsible for conducting/overseeing training, post-class assessments, record keeping and communication of end-user completion of training.
• Provides on-going support, coaching, training sessions, and observations when identified by end-users and leadership. PASS 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.as deemed needed for existing staff.
• Reviews quality of work for PASS 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 performance (registration, insurance verification, and centralized services) to department leaders.
• Performs quality assurance audits and work queue monitoring to assist in developing training needs as well as shadowing all PASS positions.
• 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.
• Works with the Information Systems department and the Essential Skills Team to stay abreast of system changes and updates throughout the health system.
• Performs other duties as assigned by PASS Leadership.

Educational/Experience Requirements:

• Minimum 3 years of related Patient Access experience in a Medical Office, Healthcare System, Hospital or Contact Center setting required.
• Prior experience in Registration/Scheduling/Pre-Certification is required, with ability to articulate understanding of registration processes, as they relate to Revenue Cycle
• Demonstrated experience in developing and conducting employee training programs, especially for scheduling and registration systems preferred. Training background should include classroom, online or one-on-one training development.
• Knowledge of Quality Improvement methods and methodology of learning and participation on a collaborative team preferred.
• Knowledge in process redesign techniques and skills (problem solving, change management/customer service skills) or process improvement preferred.
• Experience with Medical and Insurance terminology
• Excellent interpersonal skills are required, with the ability to develop strong, collaborative relationships with individuals from various levels of the organization.
• Demonstrates strong leadership attributes (strategic thinking, problem solving, change management, customer service skills), ability to multi-task and excellent organizational skills.
• Excellent oral and written communication and presentation skills.
• Must demonstrate high attention to detail and accuracy.
• Proficiency with Microsoft Office and Outlook required. Strong analytical skills preferred.
• Experience with registration/revenue cycle in Epic, preferred.

Educational/Experience Requirements:

• High school diploma or GED required. Associate degree in a Healthcare related field or Business Administration preferred.
• Equivalent combination of education and or experience in a related field in lieu of degree

Required License/Certifications:

• CHAA preferred, required within 6 months of hire (Certified Healthcare Access Associate).
• Epic Credentialed or obtained within 12 weeks of hire.

Working Conditions, Equipment, Physical Demands:

There is a reasonable expectation that employees in this position will not be exposed to blood-borne pathogens.

Physical Demands – Light work. Exerting up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects. If the use of arm and/or leg controls requires exertion of forces greater than that for sedentary work and the worker sits most of the time, the job is rated for light work. The physical demands and work environment that have been described are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions in accordance with the Americans with Disabilities Act. The above job description is an overview of the functions and requirements for this position. This document is not intended to be an exhaustive list encompassing every duty and requirement of this position; your supervisor may assign other duties as deemed necessary.