QAe - Quality

24 hours ago

Chennai, India WorldSource Healthcare Full time

Chennai, India

**QAE - Quality**:
**Job Code**: WSI-Quality-1D

**Department**: Quality

**Function Category**: Medical Billing/AR

**Group/Grade**:1D

**Designation**: QAE - Quality

**Reporting to**:Assistant Manager - Quality

**Role Details**:
This role is primarily focuses on performing on all billing and AR audits

**Area of responsibility**:

- Should have the end to end RCM knowledge and be capable to audit Demo, Eligibility, Charge Entry, Payments, Rejections, AR follow up and Denials
- To do Focus and Process audit
- To conduct ‘Ramp up’ meeting with new agents and provide daily feedback
- Providing advice, ideas and feedback to the team on meeting quality standards
- To take initiative in addressing the global issues
- Should provide daily feedback on the errors with corrective and preventive actions
- To be part of new projects transition for assigned project
- To learn new specialties, process/scopes
- Should perform audits for the minimum 5% or more
- Identifying inefficient or ineffective users and giving constructive feedback for their improvement
- Need to prepare daily and weekly reports
- Need to prepare the Monthly quality reports and conduct monthly meeting with the operation team
- Should identify the process gap’s and provide feedback to the operation team
- Should address focussing and improvement areas for each project
- Should address the top errors which impact the quality score and provide the quality and error trends
- Account Manual questions should be prepared
- Should monitor the agent’s calls and provide the appropriate feedback

**Behaviour Competencies / Knowledge required and desirable**:

- Reporting Research Results
- Analyzing & Auditing Skill
- Ability to Understand Process and deliver as per client needs
- End to End RCM Knowledge
- Internal Communication
- Attention to Detail
- Administrative Writing Skills

**Excellent skills in (desirable)**:

- Proficient in MS office/ Typing Skills
- Good Analytical Skill
- Good Communication Skills
- Coaching Skills

**Working Relationships/ Span of the role**:

- **Internal** - QAE’s, SQAE, Assistant Manager
- **External** - Clients (Specify name if any)

**Qualifications**:

- Graduate in any Stream or equivalent;
**Experience (No. of years)**:

- Minimum 4 Years of Healthcare Experience

**Location**: Chennai

**Other special requirement**: Should have the experience into Quality for the minimum of 1 year

**Availability of role**:High

**Criticality of the role**:High

**Growth**:Horizontal

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