Responsible for ensuring the accuracy of workflow and standard operating procedure  documentation and developing, maintaining and measuring the quality of the billing and collection process through the design and implementation of best practices, execution of audit process and management reporting of audit results. 

Responsibilities include periodic review of workflow documentation along with the identification of audit process opportunities, developing audit guidelines that ensures financial and operational objectives of the billing and collections department, defining the documentation and support needed to facilitate the audit program and communicate results to provide performance feedback and continuous improvement. 

Responsibilities:

Responsible for ensuring workflow and standard operating procedure documentation is accurate and up to date working in close partnership with billing & collections leadership. Responsible for enhancing billing and collection process quality through active measurement of process standards and provide continuous feedback for billing operations management and staff. Develop a framework for quality assurance discipline to ensure key processes have been identified for both financial and operational impact, forms/template development to match identified best practices, audit schedule and capacity planning, audit sampling methodology and management reporting of results.  In partnership with billing operations leads develop standards or best practices that will be measured through quality assurance audit process aligned to key financial and operational objectives. Capture and measure audit results including the development and management of audit forms/templates, audit result repository and audit sample methodology to ensure evidence and process coverage is achieved.  Develop and distribute documentation of audit results that provides staff, direct management and senior management understanding of performance and corrective action plans for areas of opportunities. Provide collaboration with billing operations leads to understand their business objectives, strategies, and on-going challenges and partner to develop and prioritize key initiatives QA experience required Experience with insurance operations, billing and collections or related field A strong understanding of billing and collections processes is essential. This includes knowledge of billing software systems, payment processing, collections strategies, dispute resolution, and compliance with relevant regulations Strong information systems understanding and ability to use internal systems as well as Microsoft Office programs Ability to dissect QA data sets, identify root causes/trends Ability to document workflows and identify opportunities for efficiencies Ability to excel independently and in a team environment Commitment to continuous learning A bachelor’s degree in a finance, business administration or related field and proven insurance-related experience Leadership and management experience Minimum of 5 years experience in an analytical role Aptitude for learning is required