Quality Analyst – Medical Billing
We are seeking a skilled and detail-oriented Quality Analyst for our medical billing team. As a Quality Analyst, you will play a critical role in ensuring the accuracy and compliance of medical billing processes, thereby contributing to the financial success of our healthcare organization. Your primary responsibility will be to conduct comprehensive audits of medical billing and coding activities to identify potential errors, discrepancies, and areas for improvement. Your expertise in medical billing regulations, coding guidelines, and industry best practices will be essential to maintain the highest standards of quality and efficiency in our billing operations
Responsibilities
- Perform regular audits of medical billing processes, focusing on accuracy, completeness, and compliance.
- Analyze billing records, claims, and supporting documentation to identify potential errors or irregularities.
- Review audit findings and discrepancies, and create comprehensive reports with clear documentation of errors and recommendations for improvement.
- Collaborate with the billing team and other stakeholders to resolve identified issues and prevent recurring errors.
- Track and monitor corrective actions taken in response to identified discrepancies.
- Stay up-to-date with changes in medical billing regulations, payer policies, and industry trends, and ensure our billing processes align with the latest requirements.
- Identify opportunities to streamline billing procedures, improve efficiency, and reduce billing errors.
- Suggest and implement process improvements and best practices to enhance the overall quality and productivity of the billing department.
- Support the continuous professional development of the billing team to enhance their skills and knowledge in medical billing.
- Utilize data analysis tools and software to assess billing performance metrics, track key performance indicators (KPIs), and report on trends.
Skills/Experience
- Bachelor’s degree.
- Proven experience as a Quality Analyst or in a similar role within medical billing or revenue cycle management.
- In-depth knowledge of medical billing regulations, coding guidelines, and payer policies (CPT, ICD-10, HCPCS, etc.).
- Strong analytical skills with the ability to identify patterns, trends, and potential issues from large datasets.
- Detail-oriented and meticulous in conducting audits and preparing reports.
- Excellent communication skills to effectively communicate audit findings and recommendations to team members and stakeholders.
- Proficiency in using billing software, EHR systems, and data analysis tools.
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If you meet the qualifications and are interested in this opportunity, please share your details with hr@medconverge.in