Analyst Quality Assurance

  Doctors Vacancy

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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