DescriptionIn our time of Company growth, we are seeking a Revenue Cycle Quality Assurance Manager
Work Location: Bradenton, FL
As part of this role, you will:- Develop, implement, and maintain a comprehensive quality assurance program for revenue cycle operations.
- Conduct audits and quality reviews of registration, insurance verification, coding support functions, charge capture, billing, accounts receivable, payment posting, denials management, and collections processes.
- Monitor compliance with federal and state regulations, payer requirements, HIPAA standards, and organizational policies.
- Analyze quality metrics, identify trends, and prepare reports for leadership regarding performance indicators and audit findings.
- Collaborate with Revenue Cycle leadership to develop corrective action plans and monitor progress toward quality improvement goals.
- Identify process gaps, operational risks, and opportunities to improve revenue integrity and reimbursement outcomes.
- Serve as a subject matter expert for revenue cycle, quality standards, and regulatory requirements.
- Develop and deliver training and educational programs based on audit findings and process improvement opportunities.
- Partner with operational leaders to establish performance benchmarks and quality metrics.
- Monitor payer denials and audit outcomes to identify recurring issues and recommend solutions.
- Assist with preparation for internal and external audits, regulatory reviews, and accreditation surveys.
- Ensure proper documentation and maintenance of quality assurance records and reporting tools.
- Support continuous improvement initiatives aimed at maximizing revenue capture, reducing denials, and improving patient financial experience.
Requirements- Bachelor's degree in healthcare administration, Business Administration, Finance, Accounting, or a related field required.
- Master's degree preferred.
- Minimum of five (5) years of progressive revenue cycle experience in a healthcare environment.
- Minimum of three (3) years of leadership or supervisory experience preferred.
- Experience with revenue cycle auditing, quality assurance, compliance monitoring, and process improvement initiatives required.
- Experience with physician practice, ambulatory care, FQHC, or multi-specialty healthcare operations preferred.
