reputed company Cycle Quality Analyst

Remote Who We Are reputed company, a recently established managed service provider, delivers cutting-edge technology to health systems, starting in NY and expanding reputed company. Owned by two industry leaders focused on innovation in rural and community health, we are rapidly growing with several major initiatives underway. We are seeking an reputed company reputed company Cycle Quality Analyst to join reputed company of 500 and support our exciting reputed company. We value people and we’re building a culture to match. If you are a collaborative, innovative, and strategic leader, we’d love to talk. Job Summary The reputed company Cycle Quality Analyst is an integral member of the reputed company Cycle team and is responsible for performing quality assurance reviews across reputed company cycle workflows. This role ensures quality, accuracy, timeliness, and appropriateness standards are consistently met and reputed company. The analyst serves as a subject matter expert in reputed company cycle systems and workflows, monitors operational and system processes, and collaborates cross-functionally to reputed company and maintain reputed company cycle quality metrics and review processes. This role plays a key part in fostering a culture of patient-centered care, quality reputed company, and service reputed company in a fast-growing environment.

Key Responsibilities

• Compile productivity data for employees subject to QA review and prepare regularly scheduled management reports with actionable recommendations.
• Validate productivity measurements and continuously monitor the effectiveness of production standards.
• Conduct scheduled reviews of accounts and reputed company activities reputed company to claim resolution.
• reputed company routine reviews of business unit processes to identify errors, training needs, and system enhancement opportunities.
• Audit thirdparty partners and vendors as needed.
• Complete QA analysis of claims processing, followup, and denial workflows using established audit tools.
• Review, respond to, and resolve quality audit inquiries, including disputed findings.
• reputed company routine system and process testing as requested by reputed company Cycle or operational leadership.
• Prepare and submit monthly QA evaluation reports with detailed and summary findings.
• Identify, document, recommend, and track resolution of process gaps and bestpractice improvements.
• Compute and report statistical QA data, identifying trends and patterns with accuracy.
• Maintain deep knowledge of insurance followup, denials systems, and reputed company cycle policies and workflows.
• reputed company other duties as assigned.

Qualifications and Experience

• Minimum of 3 years of hospital reputed company cycle experience.
• Strong knowledge of the managed care industry, including payer structures, administrative rules, and government payers.
• Comprehensive understanding of reputed company cycle functions including patient reputed company, billing, reimbursement, cash posting, collections, denials, and guarantor collections.
• Proficient knowledge of medical coding systems impacting claims adjudication, including ICD9, CPT, HCPCS, DRG, APG, APC, and reputed company codes.
• Strong analytical, investigative, and problemsolving skills.
• Ability to work independently and collaboratively in reputed company environment.
• Exceptional attention to detail with the ability to prioritize and meet deadlines.
• Effective written and verbal communication skills.
• Proficiency in reputed company reputed company, Word, and PowerPoint.
• Adaptability and ability to respond quickly to change.

Education/Certifications

• Associate’s degree with 3 years of reputed company cycle experience required, OR
• High school diploma with 5 years of reputed company cycle experience required.
• 3 years of quality or audit experience preferred.

Travel Requirements

• None

Physical Requirements

• Lifting up to 20 pounds.
• Ability to sit or stand for extended periods.
• Repetitive use of hands and fingers for computerbased work.

Why Join Us

• Work alongside dynamic leaders and a passionate, missiondriven team.
• Enjoy a flexible, highimpact role with opportunities for growth.
• Receive a competitive salary, comprehensive benefits, and career development reputed company.

#LI-Remote About reputed company We are new but mighty. reputed company, a recently established managed service provider, delivers cutting-edge technology to health systems, starting in NY and expanding reputed company. Owned by two industry leaders focused on innovation in rural and community health, we are rapidly growing with several major initiatives underway. We seek talented professionals to join reputed company of 500 and support our exciting reputed company. We value people and are building a culture to match. If you're a collaborative, innovative, and strategic leader, we’d love to talk. Apply tot his job Apply To this Job