Prospective Chart Reviewer Training & Quality Manager

Essential Job Functions:

• Develop and deliver training programs to new and existing prospective chart reviewers.
• Conduct onboarding, training sessions and workshops for new and existing Prospective Chart Reviewers.
• Evaluate the effectiveness of training programs and make recommendations for improvement.
• Monitor the progress of trainees and provide feedback to ensure that they meet quality standards.
• Stay up-to-date on changes in medical coding, billing, and clinical documentation requirements and ensure that training materials are updated accordingly.
• Collaborate with the Manager of Risk Adjustment, Prospective Programs to identify areas where additional training and support may be needed.
• Stay up-to-date on changes in regulatory requirements and best practices related to chart review and incorporate these into training content as needed.
• Create training materials, such as manuals, presentations, and visual aids, which are clear and concise.
• All other duties as assigned.

Other Job Functions:

• Understand, adhere to, and implement the Company s policies and procedures.
• Provide excellent customer services skills, including consistently displaying awareness and sensitivity to the needs of internal and/or external clients. Proactively ensuring that these needs are met or exceeded.
• Take personal responsibility for personal growth including acquiring new skills, knowledge, and information.
• Engage in excellent communication which includes listening attentively and speaking professionally.
• Set and complete challenging goals.
• Demonstrate attention to detail and accuracy in work product by meeting productivity standards and maintaining a company standard of accuracy.

Requirements:

Minimum Experience:

• 2+ years of clinical experience required.
• Advanced level of clinical knowledge associated with chronic disease states required.
• 5 years of Relevant chart review experience required.
• 1+ years of experience as a trainer or instructor preferred.

Education/Licensure:

• Medical Doctor or Nurse required.
• Coding Certification through AHIMA and AAPC preferred.

Skills and Abilities:

• Effective communication and presentation skills
• Ability to create and deliver effective training materials and job aids.
• Ability to provide individual coaching and support to team members.
• Ability to work independently and as part of a team.
• Strong analytical and critical thinking skills
• Excellent attention to detail and accuracy
• Proficient in Microsoft Office (Word, Excel, Outlook, PowerPoint)
  

Skills and Abilities:

Language Skills: Effective communication skills both written and verbal to work with multiple internal and external clients in a fast-paced environment. Mathematical Skills: Ability to work with mathematical concepts such as probability and statistical inference. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. Reasoning Ability: Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems. Computer Skills: Ability to create and maintain documents using Microsoft Office (Word, Excel, Outlook, PowerPoint)