Revenue Cycle Trainer and Quality Assurance Specialist

Revenue Cycle Trainer and Quality Assurance Specialist

Position Summary

This role is responsible for designing, delivering, and maintaining comprehensive training and quality assurance programs across the revenue cycle organization. This role supports both internal and outsourced revenue cycle team members by ensuring consistent onboarding, ongoing education, workflow adherence, and quality performance. This role plays a critical role in standardizing processes, improving accuracy, and driving continuous improvement in a high-volume urgent care environment.

Key Responsibilities

Training & Onboarding

• Deliver onboarding, functional-role training for all revenue cycle team members, including internal staff and outsourced vendor resources.
• Ensure new hires are trained on revenue cycle workflows, systems, payer requirements, and compliance standards.
• Conduct re-training and refresher sessions for team members as needed.
• Lead training sessions related to new workflows, system enhancements, payer changes, or regulatory updates.

Training Content & Documentation Development

• Develop, maintain, and update all revenue cycle training materials, standard operating procedures (SOPs), and workflow documentation.
• Create training content across multiple formats, including written SOPs, job aids, presentations, videos, and e-learning materials.
• Ensure documentation reflects current workflows, systems, and payer requirements.

Quality Assurance (QA) Audits

• Conduct regular Quality Assurance reviews of revenue cycle team members’ work across all functional areas (billing, payments & credits, A/R follow-up, patient billing, etc.).
• Validate adherence to documented workflows, accuracy standards, compliance requirements, and payer policies.
• Identify trends, recurring errors, and systemic workflow gaps impacting performance or compliance.

QA Reporting & Performance Tracking

• Maintain detailed QA scoring, audit results, and performance records for all revenue cycle team members.
• Prepare and distribute QA reports to leadership, highlighting strengths, gaps, and improvement opportunities.
• Track remediation progress and re-audit outcomes to ensure sustained improvement.

Coaching & Performance Improvement

• Develop targeted training plans or coaching plans for team members who fail QA audits or demonstrate ongoing performance issues.
• Partner with People Leaders to support corrective action plans and skills development initiatives.
• Provide actionable feedback and guidance to improve accuracy, efficiency, and compliance.

Collaboration & Continuous Improvement

• Support process improvement initiatives by identifying workflow inconsistencies and recommending standardization opportunities.
• Serve as a subject matter resource for revenue cycle workflows and best practices.

Compliance & Best Practices

• Ensure training and QA activities align with HIPAA, CMS guidelines, payer requirements, and organizational policies.
• Stay current on revenue cycle best practices, regulatory changes, and urgent care billing trends.

Required Qualifications

• High school diploma or equivalent required; Associate or Bachelor’s degree preferred.
• 3 years of experience in healthcare revenue cycle operations, training, quality assurance, or a related role.
• Demonstrated experience developing and delivering training programs in a healthcare or billing environment.
• Strong understanding of professional billing revenue cycle workflows.
• Familiarity with California payer requirements and regulatory considerations.

Preferred Qualifications

• Experience in urgent care or high-volume ambulatory healthcare settings.
• Experience supporting or managing outsourced/offshore revenue cycle teams.
• Familiarity with learning management systems (LMS) and QA tracking tools.
• Revenue cycle certification such as CRCR, CPB, CPC, or equivalent.

Key Competencies

• Strong instructional design and presentation skills
• High attention to detail and analytical mindset
• Ability to objectively assess performance and provide constructive feedback
• Excellent written and verbal communication skills
• Highly organized with strong documentation skills
• Collaborative and improvement-focused approach

Working Conditions

• Office or remote environment; flexibility for onsite work dictated by business needs

Reporting Relationship

• Reports to the Manager, Revenue Cycle Services