Consultancies

Posted 13 days ago

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**Provider Enrollment Internal Quality Analyst**: Ensure data accuracy through auditing and analysis. Key responsibilities involve conducting targeted and specialized audits, resolving disputes, and performing root cause analysis. Required skills include data export/import, trending analysis, and HIPAA confidentiality. Experience in healthcare quality assurance, preferably in provider enrollment, is crucial. Collaborate with leadership and staff to improve manual processes and maintain data integrity.

Compensation: Not specified
City: Not specified
Country: Not specified

Full Job Description

The Provider Enrollment Internal Quality Analyst will export and import data for applicable quality auditing databases and conduct quality assurance audits as assigned within the specified due dates in order to improve daily processing of applications and/or file maintenance transactions.

Responsibilities include:

Conduct targeted audit reviews as assigned within the specified due dates

Conduct specialized audit reviews as assigned within the specified due dates

Review and respond to quality audit disputes within the specified due dates and escalate to leadership as necessary

Respond to escalation requests as assigned within the specified due dates

Ensure data and information are sufficiently accurate and reliable

Perform trending and root cause analysis on quality assurance data to identify training or enhancement needs

Interact professionally with leadership and ancillary staff to provide appropriate and timely response to inquiries and concerns regarding provider enrollment and or file maintenance transactions for the clients Health Care programs

Make recommendations to management to improve efficiency effectiveness of current manual processes through systemic modifications

Maintain strict confidentiality of information and job files as dictated by current HIPAA requirements

Perform other duties as assigned by leadership

Full Job Description