Quality Analyst

Key Responsibilities:

Auditing and Review:

Auditing the work of medical billers and AR callers to identify errors, inconsistencies, and areas for improvement.

Process Improvement:

Participating in developing and documenting billing processes, and suggesting improvements to enhance efficiency.

Feedback and Training:

Providing feedback to medical billers and AR callers to help them improve their performance, and potentially collaborating with the training team to create remedial training programs.

Reporting:

Analyzing and reporting on quality metrics such as aging analysis, days in A/R, and top reasons for denials.

Compliance:

Ensuring compliance with all relevant regulations and guidelines related to medical billing.

Denial Management:

Assisting in identifying and resolving claim denials, and tracking reasons for denials.

Communication:

Communicating effectively with various stakeholders, including medical billers, AR callers, and senior management.

Knowledge and Skills:

Revenue Cycle Management (RCM):

Familiarity with the entire RCM process, from patient intake to collections.

Quality Assurance Principles:

Understanding of auditing concepts and principles, as well as best practices for quality assurance.

Analytical Skills:

Ability to analyze data, identify trends, and develop solutions to improve performance.

Communication Skills:

Excellent written and verbal communication skills to effectively communicate with various stakeholders.

Computer Skills:

Proficiency in using computer applications and software related to medical billing and RCM.