Quality Manager

Athenahealth

Athenahealth

Quality Assurance
Multiple locations
Posted on Friday, May 31, 2024

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

  • 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

  • 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 our vision: To create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

What’s unique about our locations?
From an historic, 19th century arsenal to a converted, landmark power plant, all of athenahealth’s offices were carefully chosen to represent our innovative spirit and promote the most positive and productive work environment for our teams. Our 10 offices 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 and implements products and services that support US healthcare: It’s our chance to create healthier futures for ourselves, for our family and friends, for everyone.

Our vibrant and talented employees — or athenistas, as we call ourselves — spark the innovation and passion needed to accomplish our 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 their best selves to work.

Our size makes a difference, too: We are small enough that your individual contributions will stand out — but large enough to grow your career with our resources and established business stability.

Giving back is integral to our culture. Our athenaGives platform strives to support 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’s Corporate 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, athenistas enjoy perks specific to each location, including commuter support, employee assistance programs, tuition assistance, employee resource groups, and collaborative workspaces — some offices even welcome dogs.

In addition to our traditional benefits and perks, we sponsor events throughout the year, including book clubs, external speakers, and hackathons. And we provide athenistas with a company culture based on learning, the support of an engaged team, and an inclusive environment where all employees are valued.

We also encourage a better work-life balance for athenistas with our flexibility. While we 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 taoperations@athenahealth.com for assistance.

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