Quality Expert
- Aquity Solutions
- 2 - 7 years
- Hyderabad
- 15 days ago
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Job Description
- Minimum 2 years of experience in RCM domain in US Health, preferably in Quality Auditor/Expert capacity in Accounts Receivables.
- Expertise in medical billing end to end RCM
- Strong knowledge on various denials and remark codes and able to take immediate action to resolve them and follow up on the claims for collection of payment
- Monitor and analyze RCM process errors
- Audit error corrections both short- and long-term
- Quantify error rates and their trends individually, by team, by client, and by client pool
- Analyze the errors to build training materials and tests
- Create automation solutions to reduce error rates
- Should be able to resolve billing issues that have resulted in delay in payment
- Responsible for call/data quality monitoring
- Provide feedback to agents using the prescribed feedback model
- Mentoring and coaching agents on process-level issues
- Monitor adherence to compliance procedures and processes
- Responsible for reporting program-level quality scores to the process owners
- Responsible for conducting calibration and performance review calls in terms of quality with clients as well as the internal team
- Conduct refresher training on the basis of the errors identified
- Perform weekly analysis aiming at improving SLA
- Perform brainstorming and root cause analysis to analyze data and provide tips or suggestions to the operation/management team
- Identify and highlight potential risk areas and recommend preventive action
- Maintaining a robust monitoring system to ensure key program metrics are adhered to and the required level of quality is maintained across the board
Job Classification
Industry: Medical Services / HospitalFunctional Area / Department: Quality AssuranceRole Category: Business Process QualityRole: Quality Auditor / InspectorEmployement Type: FreshersContact Details:
Company: Aquity SolutionsLocation(s): Hyderabad
Keyskills: Training Quality monitoring Root cause analysis Automation Claims Medical billing Billing Data quality Monitoring Auditing
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