Job Details

The Quality Analyst (QA) should be subject matter expert with a passion to educate people and would have an eye for details that enables them to identify errors. QA will also measure, monitor and improve performance of examiners in key aspects of quality including behavioral and educational through organized feedback mechanism to build competency amongst the team members. 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 toolsRequirements:* 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.It is the policy of this Company to seek and employ qualified individuals at all locations and facilities, and to provide equal employment opportunities for all applicants and employees in recruiting, hiring, placement, training, compensation, insurance, benefits, promotion, transfer, and termination. 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.