Job title: Analyst Quality Assurance
Company: Cotiviti
Job description: Description :
JOB RESPONSIBILITIES
- Responsible for claims/appeals quality monitoring
- Provide feedback to the analysts using the prescribed feedback model
- Mentoring and coaching analysts on process level issues
- Monitor adherence to compliance procedures and processes
- Responsible for reporting program level quality score to the process owners
- Responsible for conducting calibration and performance review call in terms of quality with the internal team
- Conduct refresher training based on the errors identified
- Communicate process updates by conducting a session as and when required
- Maintaining update log and sharing it with the team on a regular basis
- Perform brainstorming and root cause analysis to analyze data and provide tips or suggestions to operations/management team
- Identify and highlight potential risk areas and recommend preventive action
- Willing to work in a 24*7 work environment post training. Training will be conducted during US business hours and may last for 8 to 12 weeks
- Required to be available in the office for training and first few weeks of go-live, depending on the future pandemic conditions as well as company’s ability to resume operations from an office setting
ATTRIBUTES AND BEHAVIORS
- Develops and maintains positive working relationships with others
- Shares ideas and information and has ability to collaborate efficiently
- Assists colleagues and the team unprompted
- Takes pride in the achievement of team objectives
- Has credibility with peers and Team Leaders
- Self-motivated – driven to achieve results
- Works with a sense of urgency
- High customer service ethic – is passionate about meeting customer expectations and improving service levels
- Keeps pace with change – acquires knowledge/skills as the business evolves
- Handles confidential information with sensitivity.
- Exhibits behaviors consistent with Cotiviti Values:
- Integrity
- Passionate Client Service
- Teamwork
- Accountability
- Performance Excellence
- Continuous Improvement
RELEVANT EXPERIENCE & EDUCATIONAL REQUIREMENTS
- Medical degree (MBBS or BAMS or BHMS or BPT) with CPC/COC certification
- Minimum of one years’ experience of working as Quality Analyst or equivalent
- Experience in US Healthcare, medical coding, medical billing, RCM health plan operations strongly preferred.
- Possesses knowledge of healthcare claims payment policy and processing – specifically CMS, Medicaid regulations, AAOS, ICD-9, CPT & HCPCS, etc.
- Practical clinical experience working in a hospital/office or nursing home strongly preferred.
- Has general knowledge of medical procedures, conditions, illnesses and treatment practices
- Possesses excellent written and verbal communication skills. Ability to think logically and process sequentially with a high level of detailed accuracy and efficiency
- Has excellent personal computer skills in Microsoft Word, Excel, PowerPoint, Outlook, etc.
SKILLS & COMPETENCIES
- Strong analytical, critical thinking and problem-solving skills
- Excellent verbal and written communication skills
- Be a quick learner and proficient in application of learnings
- Excel and power point proficiency
- Strong organizational skills and adaptive capacity for rapidly changing priorities and workloads
- Ability to work well independently and maintain focus on a topic for prolonged periods of time
Expected salary:
Location: Pune, Maharashtra
Job date: Sat, 23 Jul 2022 04:52:17 GMT
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