Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

RCM Quality Manager

Job Summary: The Stateside RCM Quality Manager will report to the Quality Director. The primary responsibility of this role is to review payment and denial processes, along with claim and account details, assuring quality, accuracy, timeliness, and athena standards are maintained. The RCM Quality Manager will partner with Operations, Revenue Cycle, Product, and BPO to identify areas of opportunity in revenue cycle workflows.

Responsibilities:

Apply quality assurance expertise by closely monitoring trends, identifying transactions and processes for audits, presenting audit outcomes and recommendations to mitigate gaps to the operations team for resolution
Work closely with operational teams to resolve process ambiguity by calibrating on audit process and parameters
Build strong customer relationships and deliver customer centric solutions
Identify opportunities to enhance/improve workflows to ensure efficient, productive, and successful processes are established for payment posting and accounts receivable
Ability to identify when a function/action was performed that is not included in Standard Operating Procedures (SOPs)
Utilize audit results to report trends and recommend BPO training
Accountable for analyzing and measuring results of implemented polices, changes, and system modifications
Establish and implement interim workaround solutions as needed and communicate to all impacted users
Review customer feedback/concerns and ensure that corrective action is being taken, adhering to the plan of action
Addresses challenging situations by remaining open to alternative views
Demonstrates a strong drive to achieve meaningful results
Assist in monitoring Service Level Agreements (SLA) by BPO
Perform additional projects and job duties as assigned

Qualifications:

Bachelor’s Degree in Healthcare Administration, Business Administration, or related field preferred
5+ years of related RCM experience on front to back processes
5+ years auditing experience in a healthcare setting
Self-motivated; you are a person who takes initiative and approaches problem solving with creativity and excitement
A collaborator with excellent interpersonal skills who can work seamlessly with various teams and levels in the organization
Highly organized and can hold yourself to a deadline
Strong analytical skills
Strong proficiency in Microsoft Office Suite, specifically Excel, Word, and PowerPoint
Ability to travel 0 - 10% nationwide and internationally

About athenahealth

Here’s ourvision: To create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

What’s unique about our locations?
From an historic, 19thcentury arsenal to a converted, landmark power plant,allofathenahealth’s offices were carefully chosen to represent our innovative spirit and promote the most positive and productive work environment for our teams. Our10offices across the United States and India —plus numerous remote employees —all work to modernize the healthcare experience, together.

Our company culture might be our best feature.
We don’t take ourselves too seriously. But our work? That’s another story.athenahealth develops andimplements products and services that support US healthcare: It’sour chance to create healthier futures for ourselves, for our family and friends, for everyone.

Our vibrant and talented employees — orathenistas, as we call ourselves — spark the innovation and passion needed to accomplishour goal. We continue to expand our workforce with amazing people who bring diverse backgrounds, experiences, and perspectives at every level, and foster an environment where every athenista feels comfortable bringing theirbestselves to work.

Our size makes a difference, too: We are small enoughthatyourindividual contributionswill stand out— butlarge enoughto grow your career with ourresources and established business stability.

Giving back is integral to our culture. OurathenaGivesplatform strives tosupport food security, expand access to high-quality healthcare for all, and support STEM education to develop providers and technologists who will provide access to high-quality healthcare for all in the future. As part of the evolution of athenahealth’sCorporate Social Responsibility(CSR)program, we’ve selected nonprofit partners that align with our purpose and let us foster long-term partnerships for charitable giving, employee volunteerism, insight sharing, collaboration, and cross-team engagement.

What can we do for you?
Along with health and financial benefits,athenistasenjoy perks specific to eachlocation, including commuter support, employee assistance programs, tuition assistance,employeeresource groups, and collaborative workspaces — some offices even welcome dogs.

In addition to our traditional benefits and perks, we sponsor events throughout the year, includingbook clubs, external speakers, and hackathons. And weprovideathenistaswithacompany culturebased onlearning,the support of anengaged team,andan inclusive environment where all employees are valued.

We alsoencourage a better work-life balance forathenistaswith our flexibility. Whilewe know in-office collaboration is critical to our vision, we recognize that not all work needs to be done within an office environment, full-time. With consistent communication and digital collaboration tools, athenahealth enables employees to find a balance that feels fulfilling and productive for each individual situation.

athenahealth is committed to a policy of equal employment opportunity—that’s why we recruit and hire applicants without regard to race, color, religion, sex (including pregnancy), national origin, disability, age, sexual orientation, veteran status, genetic information, gender identity, gender expression, or any other factor prohibited by law. We’re happy to provide a reasonable accommodation, for those with a disability, to complete any part of the application process. If you are unable to access or use this online application process and need an alternative method for applying, please contact us at [email protected] for assistance.

https://www.athenahealth.com/careers/equal-opportunity

RCM Quality Manager

Athena Health

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