Role Purpose:
To design, deliver, and sustain effective training programs, monitor service quality, and implement targeted performance improvement initiatives that drive high-quality virtual visit facilitation, patient satisfaction, and revenue recovery.
Key Responsibilities:
1. Training & Development
- Identify and assess the training needs of the organization through job analysis, career paths, and consultation with managers.
- Design and deliver engaging onboarding programs for new hires, covering:
- EPIC Book-It & RTE (scheduling and insurance verification)
- Care Connect (patient engagement and communication)
- MyChart / Amwell (virtual visit facilitation)
- HelloWorld (real-time co-pay and prepayment collection)
- OneSource & payer websites (insurance verification)
- Create and maintain up-to-date SOPs, training materials, and job aids.
- Facilitate refresher sessions and upskilling programs to align with process changes or client requirements.
- Conduct system simulations and role-play activities to reinforce learning.
- Track training completion, pass rates, and retention scores.
- Create a curriculum to facilitate strategic training based on the organization's goals.
- Keep abreast of training trends, developments, and best practices.
- Effectively communicate with team members and management.
- Drive brand values and philosophy through all training and development activities.
2. Quality Assurance & Monitoring
- Monitor live and recorded calls/chats using Calabrio to ensure process adherence, service quality, and compliance with HIPAA regulations.
- Evaluate accuracy in:
- Insurance verification
- Co-pay/prepayment collection
- Documentation and EPIC updates
- Return visit scheduling
- Develop and maintain QA scoring rubrics to ensure consistent evaluation.
- Facilitate calibration sessions with other QA staff and Team Leads for scoring alignment.
- Document QA findings and provide actionable recommendations.
- Send Reports based on QA Analysis and Output
- Conduct touch base/huddles to discuss QA Output/Analysis with assigned teams
- Raise process improvement recommendations to stakeholders (Ops, Client, etc.)
3. Performance Coaching
- Analyze QA results and KPI trends via Power BI to identify improvement opportunities.
- Conduct one-on-one or group coaching sessions focused on performance gaps.
- Partner with Team Leads to create targeted action plans for low performers.
- Monitor post-coaching results and measure improvement rates.
4. Compliance & Best Practices
- Ensure all training and QA activities comply with HIPAA, patient privacy, and data security requirements.
- Promote best practices in patient communication, payment security, and system navigation.
- Collaborate with operations leadership to implement process enhancements.
Judgement
- Using data and feedback to continuously improve the programs and making recommendations for changes and improvements.
- Identify trends in training needs and program effectiveness. Use data to increase decision—making for training initiatives, subsequently improving their chances of success.
Qualifications:
- Minimum 2 years of experience in healthcare BPO training, quality assurance, or process improvement.
- Strong understanding of revenue cycle management and virtual healthcare workflows.
- Proficiency in EPIC, Care Connect, HelloWorld, and insurance verification processes.
- Experience in quality monitoring tools (Calabrio) and analytics platforms (Power BI).
- Excellent facilitation, feedback, and coaching skills.
- Strong written and verbal communication skills with the ability to train in both virtual and in-person formats.
Process Related Knowledge/ Skills
- Ability to carefully listen and negotiate with callers, especially the elders.
- Ability to effectively communicate products and services to callers.
- Experience in direct-to-consumer collections
- Knowledge of billing all state-funded/MCD-type agencies
- Experience handling Invoice submissions to payers
- Experience handling Late bill submissions
- Experience handling missing payments and Overpayments.
- Strong exp with excel, billing software, MS Office, and insurance portals