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Quality Analyst

Key Facts

Remote From: 
Full time
Senior (5-10 years)
English

Other Skills

  • Quality Control
  • Analytical Skills
  • Detail Oriented
  • Mentorship
  • Report Writing

Roles & Responsibilities

  • 5+ years of experience in US Healthcare RCM (posting transactions and AR Follow-up)
  • Thorough understanding of the provider claim lifecycle
  • Thorough knowledge of major insurance payers and common denials; knowledge of CPT codes, transaction codes and reason codes
  • Excellent written and verbal communication skills in English with strong grammar

Requirements:

  • Review teams' production for errors and inaccuracies and identify trends in denials and global issues
  • Document and publish quality scores; create cheat sheets and reference guides to improve quality
  • Mentor and coach team members to improve their quality scores; be prepared to temporarily assume AR Analyst responsibilities as needed
  • Maintain production and quality standards in line with organizational policies

Job description

Quality Analyst

- Review teams’ production for errors and inaccuracies.
- Document and publish quality scores.
- Council and mentor team members to improve their quality scores.
- Create cheat sheets and reference guides to assist teams in improving quality.
- Be able to move seamlessly into the AR Analyst role temporarily if the need
arises.
- Identify and report common trends in teams’ production, denials and any global
issues.
- Maintain production and quality standards declared by the organization.
Requirements:
- 5+ Years of experience in US Healthcare RCM in posting transactions and AR
Follow-up.
- Should have a thorough understanding of Provider claim life cycle.
- Must have thorough knowledge of major insurance payers.
- Must have thorough knowledge of common denials.
- Must know standard practices of RCM.
- Must have understanding of common acronyms and nomenclature in US
Healthcare.
- Should have excellent written and communication skills in English. Good
grammar is a must.
- Must have fair knowledge of common CPT codes, transaction codes and reason
codes.

Experience: 5+ Years

Individual Contributor

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