Job Details

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.
• Thorough understanding of provider claim life cycle.
• Thorough knowledge of major insurance payers.
• Thorough knowledge of common denials.
• Standard practices of RCM.
• Understanding of common acronyms and nomenclature in US Healthcare.
• Excellent written and communication skills in English. Good grammar is a must.
• Fair knowledge of common CPT codes, transaction codes and reason codes.