Quality Auditor - Contact Center (Remote, Remote, US)

Firstsource

Salary: $45k
Experience: 2+ yrs
Location: United States
Job type: Full-time

Required skills

ICD-10
ICD-9
CPT
claims processing systems
medical terminology

About the role

Job Title: Quality Analyst – Capability Development

Job Type: Full Time

FLSA Status: Non-Exempt/Hourly

Grade: G

Function/Department: Health Plan and Healthcare Services

Reporting to: Manager- Capability Development

Pay Rate: $22/hr

Job Summary

The primary purpose of this position is to identify, analyze and improve quality, to ensure delivery of SLA quality metrics per client contract. This includes but is not limited to auditing, creating & reviewing quality reports, trending and analyzing audit findings, answering agent questions, client communications, training, continuing education programs assisting in the development of employees so they can keep pace with the changing needs of the organization, and to ensure that processes are in place to meet the goals and objectives of the client and the organization. 

Key Accountabilities/Responsibilities:  

Work with minimal supervision using professional skills, discretion and sensitivity while addressing various quality and training issues.

Work as a team member in determining departmental needs.

Serve as a resource for employees and management.

Provide quality review and training for the further development of each employee.

Work well with a variety of individuals and resolve issues professionally.

Be a leader who interfaces with various operations management personnel.

Provide timely quality follow-through in the form of audits and development sessions.

Performs other work-related duties as assigned.

Qualifications Required:  

High school diploma or equivalent required

2 to 3 years of relevant claims experience

Thorough knowledge of medical terminology, claim processing procedures/systems, auditing, and a thorough understanding of claim protocols and industry standards and CMS regulations as it relates to claims payment and compliance.

Knowledge and work experience with ICD9, ICD10, CPT and different coding systems (preferable)

About Firstsource

Provides business process management services for healthcare and financial sectors.

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