START Quality Assurance/Billing Manager- Woodbridge, VA at Woodbridge

Job Description

Responsibilities:
In addition to our corporate plan, assists in designing a system of measuring key indicators of success specific to Virginia and the START Model.
Under the direction of the START Director, develop and maintain procedures necessary for efficient and successful submission of reports as well as inputting of billing entries.
Works closely with ESUCP billing to assure successful claims: determine and maintain client eligibility reports; assist in maintaining and tracking client authorizations and service denials; participate in the quantitative review of documentation needed for clean claims, and work with ESUCP billing in responding to claim denials.
Analysis and resolution of remittance information and/or reasons for denial or pending of claims submitted. Provide regular reports to monitor projected billing vs. actuals.
Under direction of START Director, develop quality assurance measures for the timely and comprehensive submission of data entry compliance for SIRS, Evolv and other programs as required.
Provide client medical record review for quantitative and qualitative compliance for:  START program and fidelity requirements, VA state licensing requirements, Medicaid and billing requirements, and all other applicable regulatory oversight compliance. Provide regular Personnel Record review to meet all federal, state and ESUCP compliance (including training compliance) for all START employees.
Assure compliance with all ESUCP Quality Assurance requirements (Fire Drills, CIR submission, Disaster Drill compliance, Personnel Outcome Questionnaire etc.)
Develops reports necessary for compliance review in all areas, makes recommendations for improvement.
Participate on the ESUCP QM Committee, as well as chairs the VA START Quality Assurance Committee.
Provide leadership and oversight on annual Quality Improvement activity.
Willingness to travel as job duties will be fulfilled in Woodbridge, VA and Charlottesville, VA.

Job Requirements

Qualifications:
Minimum of a bachelor’s degree in human services or related field and no less than one year of relevant experience.
Five or more year’s supervisory experience in a mental health/developmental disabilities setting.
Knowledge of the Virginia MH and I/DD systems of care.
Maintain valid driver’s license and insurance for personal and agency vehicles utilized for work.
Complete within specified time period the trainings as required by agency and service model.
Competence in Microsoft office applications including excel, word, outlook PowerPoint and access. *mw
Country: USA, State: Virginia, City: Woodbridge, Company: EasterSeals UCP.