![Michael Page](https://media.trabajo.org/img/noimg.jpg)
Quality & Outcome Improvement Analyst
1 week ago
About Our Client
leading Health-Tech clients which offers electronic health records, practice management, revenue cycle management and data analytics for doctors, and currently has software for dermatologists, orthopaedic surgeons, gastroenterologists, plastic surgeons, otolaryngologists, urologists and pain management physicians.
Some of their key highlights being-
· South Florida Business Journal, Best Places to Work 2024
· Inc. 5000 Fastest-Growing Private Companies in America 2023
· Company of the Year | 2023 BIG Innovation Awards
. Fastest-Growing Company of the Year - Large (Bronze) | 2022 Best in Biz Awards
Job Description
Play a critical role in meeting productivity targets, delivering a high level of customer service, and ensuring overall service delivery is consistently maintained at the highest standards while ensuring ModMed's billing and compliance processes and Standard Operating Procedures (SOPs) are followed.
* Responsible for identifying and addressing opportunities to improve workflows and reduce non-meaningful touches by analysing trends on inflows of claim-level assignments.
* Set up and manage online portals following the requirements and payer details provided by global partners, including, but not limited to, creating W9 forms and following up with payers.
* Work claims escalated from global partners, practices and onshore teams as per Standard Operating Procedures. (SOPs). Including but not limited to:
* Analyze claims addressed for credentialing issues from global partners and work closely with onshore to resolve credentialing issues.
* Review claims assigned to practice for quality and determine if decision tree enhancements will prevent future escalation of a similar claim.
* Analyze Dashboards/Reports for production and AR trends to identify quality issues; sample the claims and fill out Quality Analysis forms.
The Successful Applicant
5+ years of related working experience in core Provider RCM out of which minimum 2 years as SME, Asst. Team Lead, Team Lead , QA, QA Lead, etc. within a professional setting.
* Strong understanding of RCM Processes and best practices - knowledge at a transaction level is required.
* Experience working on process improvements/ six sigma quality projects preferred.
* Proven expertise in the front-end and back-end functions of the provider side of US Healthcare RCM such as charges, payment posting , AR follow ups, denials, eligibility, etc.
* Comprehensive understanding of the full revenue cycle process for claim submission, medical insurance policies, and ICD-10 and CPT coding guidelines.
* Proven knowledge of various insurance carriers, including Medicare, private HMOs, PPOs, Capitation and Workers' Comp.
* Advanced excel skills such as the ability to use formulas to analyze data, create and format pivot tables and templates, use and conditional formatting and validationWilling to work in US shifts, 5 days WFO
-
RCM Quality and Outcome Improvement Manager
1 week ago
Hyderabad, Telangana, India ModMed Full timeWe are united in our mission to make a positive impact on healthcare. Join Us South Florida Business Journal, Best Places to Work 2024 Inc. 5000 Fastest-Growing Private Companies in America 2023 Company of the Year | 2023 BIG Innovation Awards Fastest-Growing Company of the Year – Large (Bronze) | 2022 Best in Biz Awards Who we are: We...
-
RCM Quality and Outcome Improvement Manager
1 week ago
Hyderabad, Telangana, India Modernizing Medicine Full timeWe are united in our mission to make a positive impact on healthcare. Join Us South Florida Business Journal, Best Places to Work 2024 Inc. 5000 Fastest-Growing Private Companies in America 2023 Company of the Year | 2023 BIG Innovation Awards Fastest-Growing Company of the Year – Large (Bronze) | 2022 Best in Biz Awards Who we are:We Are Modernizing...
-
RCM Quality and Outcome Improvement Manager
4 weeks ago
Hyderabad, Telangana, India Modernizing Medicine Full timeWe are united in our mission to make a positive impact on healthcare. Join Us South Florida Business Journal, Best Places to Work 2024 Inc. 5000 Fastest-Growing Private Companies in America 2023 Company of the Year | 2023 BIG Innovation Awards Fastest-Growing Company of the Year – Large (Bronze) | 2022 Best in Biz Awards Who we are:We Are Modernizing...
-
RCM Quality and Outcome Improvement Manager
3 weeks ago
Hyderabad, Telangana, India Modernizing Medicine Full timeWe are united in our mission to make a positive impact on healthcare. Join Us South Florida Business Journal, Best Places to Work 2024 Inc. 5000 Fastest-Growing Private Companies in America 2023 Company of the Year | 2023 BIG Innovation Awards Fastest-Growing Company of the Year – Large (Bronze) | 2022 Best in Biz Awards Who we are:We Are Modernizing...
-
Hyderabad, Telangana, India ModMed Full timeWe are united in our mission to make a positive impact on healthcare. Join Us South Florida Business Journal, Best Places to Work 2024 Inc. 5000 Fastest-Growing Private Companies in America 2023 Company of the Year | 2023 BIG Innovation Awards Fastest-Growing Company of the Year – Large (Bronze) | 2022 Best in Biz Awards Who we are: We...
-
Cim Amp Associate 2
1 week ago
Hyderabad, Telangana, India RSM US LLP Full timeAs a member of our CIM group, working specifically with Tax Accounting Methods & Periods (AMP), you will be responsible for the following job duties which are focused around two core concepts: your technical and quality expertise and delivering excellent client service:Delivery of AMP projects supervised by regional and WNT AMP specialists, including revenue...
-
Quality Assurance Trainee
1 week ago
Hyderabad, Telangana, India RedeFin Capital Full timeDescription:RoleQuality Analyst ExperienceTraineeLocationHyderabadIndustry Type: and nbsp;ITServices and amp; ConsultingEmployment Type: andnbsp;Full Time Permanent andnbsp; andnbsp;andnbsp;KeyResponsibilitiesand nbsp;1. andnbsp;Assist QA Engineers in understanding product requirements anddesigning test plans.2.and nbsp;Participate in designing developing...
-
Quality Analyst
1 week ago
Hyderabad, Telangana, India Hiresquad Resources Full timeQuality Analyst/ International ProcessVoice Process/ BPO Position at A Leading BPO in Hyderabad5 DAYS WORKINGNight ShiftsImmediate Joiners OnlyQualification:Graduate or Post Graduate with:Min 1+ year experience working as a Quality Analyst in a BPOExperience in International Voice Process as a Quality Analyst (MANDATE)Well-versed with Quality Metrics and...
-
Quality Analyst
1 week ago
Hyderabad, Telangana, India Hiresquad Resources Full timeQuality Analyst/International Process Voice Process/BPO A Leading BPO - Hyderabad 5 DAYS WORKING Night Shifts Immediate Joiners Only Work From Office Qualification: Graduate or Post Graduate Experience Required: Min 1+ year experience working as a Quality Analyst in a BPO Experience working in International Voice Process as a Quality...
-
Quality Analyst
1 week ago
Hyderabad, Telangana, India Hiresquad Resources Full timeQuality Analyst/ International ProcessVoice Process/ BPOA Leading BPO - Hyderabad5 DAYS WORKINGNight ShiftsImmediate Joiners OnlyWork From OfficeQualification: Graduate or Post GraduateExperience Required-* Min 1+ year experience working as a Quality Analyst in a BPO* Experience working in International Voice Process as a Quality Analyst(MANDATE)*...
-
Quality Analyst
1 week ago
Hyderabad, Telangana, India MarketStar Full timeIf you are a current employee who is interested in applying to this position, please navigate to the internal Careers site to apply. Role: Quality Analyst.Experience: 3-5 Years.Location: Hyderabad. About Us: At Regalix, A MarketStar company, we are on a mission to help some of the world's leading technology companies achieve scale and success by providing...
-
Senior Quality Assurance Analyst
1 week ago
Hyderabad, Telangana, India Epiq Full timeDescription : The Senior Software QA Analyst provides and ensures the overall assurance on the quality of product by implementing and adhering to the best practices in automation and manual testing processes. Job Responsibilities Write functional test cases for new enhancements and subsequently automate them Ensure overall application test coverage ...
-
Sr. Quality Analyst
1 week ago
Hyderabad, Telangana, India Construction Specialties, Inc Full timeJob Description - Sr. Quality Analyst Job DescriptionDescriptionWe are looking for a Sr. Quality Analyst for our newly established Hyderabad Global Shared Services Office. The Sr. QA Analyst position is that of a functional test and being SPOC guiding the team. This person will work closely with the application development manager to identify weaknesses in...
-
Quality Assurance
1 week ago
Hyderabad, Telangana, India Wipro Full timeJob description Your role is critical in maintaining and improving the overall quality standards within the organization You will lead a team of quality analysts and collaborate with cross-functional teams to drive continuous improvement in processes Key Responsibilities:Team Leadership:Lead, mentor, and coach a team of quality analysts Set clear performance...
-
Senior Data Quality Analyst
1 week ago
Hyderabad, Telangana, India PureSpectrum Full timeWho We Are:PureSpectrum is a fast-growing platform focused on market research and insights. We simplify technology for researchers to collect and utilize consumer data efficiently.PureSpectrum conducts over 115 million online interviews yearly through our Marketplace. Our unique respondent-level scoring system, PureScore, sets us apart in the industry....
-
CAP Quality Analyst
1 week ago
Hyderabad, Telangana, India ADCI HYD 20 SEZ Full timeCAP Quality Team is seeking Japanese Language Specialist who will work closely with Ops, Program and Front-line teams to define opportunities for optimizing the quality and communication processes and be the single threaded owner for translation quality for JP. This role requires the ability to work autonomously in a fast-paced environment, while adhering to...
-
CAP Quality Analyst
1 week ago
Hyderabad, Telangana, India ADCI HYD 20 SEZ Full timeCAP Quality Team is seeking Japanese Language Specialist who will work closely with Ops, Program and Front-line teams to define opportunities for optimizing the quality and communication processes and be the single threaded owner for translation quality for JP. This role requires the ability to work autonomously in a fast-paced environment, while adhering to...
-
Business Analyst
1 week ago
Hyderabad, Telangana, India Decent Full timeJob OverviewDecent is a high-growth venture-backed startup in the US with a mission to help employers provide more affordable healthcare to their employees.We are seeking a skilled Business Analyst & Quality Assurance Specialist to join our dynamic product team in Hyderabad, India. The ideal candidate will collaborate closely with product teams, business...
-
Business Analyst
1 week ago
Hyderabad, Telangana, India Decent Full timeJob Overview Decent is a high-growth venture-backed startup in the US with a mission to help employers provide more affordable healthcare to their employees. We are seeking a skilled Business Analyst & Quality Assurance Specialist to join our dynamic product team in Hyderabad, India. The ideal candidate will collaborate closely with product teams, business...
-
Senior Quality Assurance Analyst
1 week ago
Hyderabad, Telangana, India Epiq Full time:The Senior Software QA Analyst provides and ensures the overall assurance on the quality of product by implementing and adhering to the best practices in automation and manual testing processes.Job ResponsibilitiesWrite functional test cases for new enhancements and subsequently automate themEnsure overall application test coverageUnderstand requirements...