GENERALSUMMARY/ OVERVIEW STATEMENT
TheQA Reviewer/Analyst, under the direction of the Director, is responsible for identifyingand mitigating risk of denials to the Department and ensuring highest qualityof work by the Admissions Counselors via daily management of Patient AccessEPIC WQs (Patient/Account/Claims); weekly review of the in-house high dollarOntrac accounts; monitoring of DFCI patients in BWH beds; oversight of denialsin conjunction with Department Team Leads and Manager, among otherresponsibilities aimed at improving the financial health of the Departmentoverall. Identify training needs of Department and individual staff members.Track denials for all staff members.
In addition, the QA Reviewer/Anaylst will act as a Department resource, whichmay include assisting in the training of new hires, or the retraining ofexisting hires. Will act as lead for teams, as assigned, which can vary. Willassist Team Leads and Manager in reviewing Ontrac exceptions and tracking KPIand meeting Department expectations, e.g., elective teams days out, urgent teamcompleted post discharge metrics. Will assist Management team in projects asnecessary and assigned.
PRINCIPALDUTIES AND RESPONSIBILITIES
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