Manager, Front End QA

Ventra is a leading business solutions provider for facility-based physicians practicing anesthesia, emergency medicine, hospital medicine, pathology, and radiology. Focused on Revenue Cycle Management, Ventra partners with private practices, hospitals, health systems, and ambulatory surgery centers to deliver transparent and data-driven solutions that solve the most complex revenue and reimbursement issues, enabling clinicians to focus on providing outstanding care to their patients and communities.

The Front End Process Quality Manager is responsible for overseeing and enhancing the quality and efficiency of all front-end revenue cycle processes, including intake, demo entry, schedule reconciliation and charge entry. This role involves ensuring that these processes align with regulatory standards and organizational policies, while optimizing patient satisfaction, minimizing errors, and improving overall revenue cycle outcomes.

Process Quality Management:

• Develop, implement, and monitor quality assurance processes for front-end revenue cycle functions.
• Ensure that intake, demo entry, schedule reconciliation and charge entry processes are performed in compliance with payer regulations and internal policies.
• Continuously assess the accuracy and efficiency of front-end activities and develop improvement initiatives.

Team Management:

• Lead and manage a team of quality assurance staff or front-end RCM personnel.
• Conduct regular training sessions to improve team knowledge on quality standards, regulatory requirements, and workflow improvements.
• Mentor and coach team members to maintain high performance levels and handle performance reviews.

Compliance and Auditing:

• Conduct regular audits of front-end processes to ensure compliance with payer contracts, HIPAA regulations, and other healthcare guidelines.
• Ensure proper documentation, accuracy, and compliance with federal, state, and organizational policies.
• Collaborate with internal and external auditors during reviews and prepare corrective action plans when needed.

Performance Metrics and Reporting:

• Establish and monitor key performance indicators (KPIs) for front-end RCM processes.
• Generate and analyze reports on quality performance, identifying trends, issues, and opportunities for improvement.
• Present findings to senior leadership and collaborate with cross-functional teams to enhance RCM performance.

Process Improvement:

• Identify bottlenecks and inefficiencies in front-end processes and work with IT, operations, and clinical departments to streamline workflows.
• Lead initiatives to automate and improve technology solutions in intake, demo entry, schedule reconciliation and charge entry functions.
• Implement best practices across all front-end RCM processes to optimize patient experience and revenue capture.

Stakeholder Collaboration:

• Collaborate with Patient Access, Billing, Coding, and other RCM teams to ensure seamless integration of front-end and back-end processes.
• Work closely with IT, Finance, and Compliance departments to support overall RCM goals and objectives.

Training and Development:

• Design and implement training programs for front-end staff on quality standards, best practices, and regulatory changes.

Ensure ongoing education on evolving payer requirements and changes in healthcare regulations

• Bachelor's degree in any related field.
• Minimum of 8+ years of experience in US Healthcare RCM industry, with 3 years in a supervisory or managerial role.
• Experience with performance auditing, process improvement, and regulatory compliance within the healthcare industry.

• Strong understanding of front-end RCM processes, including intake, demo entry, schedule reconciliation and charge entry.
• Exceptional analytical and problem-solving skills, with the ability to make data-driven decisions.
• Excellent communication, leadership, and project management skills.
• Knowledge of regulatory standards (e.g., HIPAA, CMS guidelines).

Ventra Health Values:

• Excellence:

Encourage and promote excellence in partnering with and delivering results to our clients.

• Accountability:

Accept responsibility for achievement of objectives and key results and be answerable for outcomes.

• Teamwork:

Embrace the power of one team to create and deliver value to clients by delivering consistent outcomes.

• Transparency:

Openly share ideas and information to promote trust, increase engagement and gain new perspectives.

• Inclusiveness & Diversity:

Embrace and celebrate diversity and promote an environment of inclusiveness.

• Recognition:

Acknowledge, embrace and celebrate colleague contributions that align with the company vision.

• Growth:

Provide consistent opportunities for colleagues to expand their capabilities & knowledge.

Equal Employment Opportunity (Applicable only in the US)

Ventra Health is an equal opportunity employer committed to fostering a culturally diverse organization. We strive for inclusiveness and a workplace where mutual respect is paramount. We encourage applications from a diverse pool of candidates, and all qualified applicants will receive consideration for employment without regard to race, color, ethnicity, religion, sex, age, national origin, disability, sexual orientation, gender identity and expression, or veteran status. We will provide reasonable accommodations to qualified individuals with disabilities, as needed, to assist them in performing essential job functions.

Recruitment Agencies

Ventra Health does not accept unsolicited agency resumes. Ventra Health is not responsible for any fees related to unsolicited resumes.

Solicitation of Payment

Ventra Health does not solicit payment from our applicants and candidates for consideration or placement.

Attention Candidates
Please be aware that there have been reports of individuals falsely claiming to represent Ventra Health or one of our affiliated entities Ventra Health Private Limited and Ventra Health Global Services. These scammers may attempt to conduct fake interviews, solicit personal information, and, in some cases, have sent fraudulent offer letters.

To protect yourself, verify any communication you receive by contacting us directly through our official channels. If you have any doubts, please contact us at Careers@VentraHealth.com to confirm the legitimacy of the offer and the person who contacted you. All legitimate roles are posted on https://ventrahealth.com/careers/.