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Quality Analyst

Role overview

Qualifications

  • 5+ years of experience in US Healthcare RCM, including posting transactions and AR follow-up.
  • Thorough understanding of the provider claim life cycle.
  • Thorough knowledge of major insurance payers and common denials.
  • Strong knowledge of standard RCM practices and familiarity with common CPT codes, transaction codes, and reason codes; excellent written and verbal English communication.

Responsibilities

  • Review teams' production for errors and inaccuracies.
  • Document and publish quality scores.
  • Counsel and mentor team members to improve their quality scores.
  • Create cheat sheets and reference guides to assist teams in improving quality.

About the company

CPSI logo

CPSI

Digital Health & Health Tech

CPSI is a leading provider of healthcare solutions and services for community hospitals, their clinics and post-acute care facilities. Founded in 1979, CPSI is the parent of four companies – Evident, LLC, American HealthTech, Inc., TruBridge, LLC, TruCode, LLC, and iNetXperts, Corp. d/b/a Get Real Health. Our combined companies are focused on helping improve the health of the communities we serve, connecting communities for a better patient care experience, and improving the financial operations of our customers. Evident provides comprehensive EHR solutions for community hospitals and their affiliated clinics. American HealthTech is one of the nation’s largest providers of EHR solutions and services for post-acute care facilities. TruBridge focuses on providing business, consulting and managed IT services, along with its complete RCM solution, for all care settings. Get Real Health focuses on solutions aimed at improving patient engagement for individuals and healthcare providers. TruCode provides medical coding software that enables complete and accurate code assignment for optimal reimbursement. For more information, visit www.cpsi.com.

Company details

Company typeLarge
IndustryDigital Health & Health Tech
Company size1001 - 5000

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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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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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