Quality Analyst

QA will also be accountable for tracking, documenting and reporting audit reports in addition to trending and analysis.

Roles & Responsibilities

Have an eye for details that enables them to identify errors

Ensure that all policies, processes, and audit findings are properly documented

Conduct regular Feedback sessions for Agents.

Generating daily, weekly & monthly Quality Reports

Should have knowledge of 7 tools of quality Preferred

Identify and analyses Quality assurance issues and recommend appropriate solutions

Measure, monitor and improve performance of examiners in key aspects of quality

Collaborate with stakeholders to align quality assurance and execute quality control procedures.

Ensure there are no defects on ATA performance

Maintain good interpersonal and communication skills [Oral and Written] with auditees and business areas Conduct RCA 5 Y analysis Pareto analysis on monthly audit data and publish the findings

Hands on experience with Quality tools

Requirements:

High school diploma or equivalent required

2 to 3 years of relevant Domain/Industry experience with at least 1 to 2 years of experience in claims auditing

Thorough knowledge of medical terminology, claim processing procedures/systems, auditing, and a thorough understanding of claim protocols and industry standards and CMS regulations as it relates to claims payment and compliance.

Knowledge and work experience with ICD9, ICD10, CPT and different coding systems (preferable)

We are an Equal Opportunity Employer. All qualified applicants are considered for employment without regard to race, color, age, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by federal, state, or local law.

To achieve this, we are dedicated to taking affirmative action to employ and advance in employment qualified individuals with disabilities, disabled veterans, and other eligible veterans.