This position is responsible for objectively auditing assigned business areas to assess effectiveness of operational, regulatory, and contractual goals and guarantees. The Quality Analyst will also regularly provide root-cause and trending analysis, provide recommendations to business owners for improvements, and when required, assist with corrective action measures and support training initiatives involving quality programs.
Prepare and participate in external audits in the capacity of Subject Matter Expert (SME) on quality auditing, when required
- Participate in any/all new and continuing training and educational activities necessary in providing a broad understanding of the business areas assigned for audit. This is in addition to the completion of any activities necessary for the maintenance of professional affiliations or organizational requirements as needed.
- Subjectively audit assigned business areas based on parameters approved by area business owners and within established timeframes.
- Manage the administrative functions of the auditing process which includes, but not limited to, record retention, communication, correction oversight and reporting.
- Prepare, validate and communicate regular and timely reporting of audit results to business owner’s and senior management. This may include meeting participation with prepared presentations
- Respond to ad hoc reporting requests based on business needs
- Trend audit results and provide root cause analysis to business owners, when applicable
- Identify and escalate any audit results that require immediate remediation via corrective action and provide support and collaboration to business owners as applicable
- Support training initiatives regarding quality programs via documentation or mentoring as needed. This may include participation in associate class room training
- Responsible for updating/revising quality program policies as business and regulatory requirements change.
- Responsible for developing standardized reporting templates for reporting audit results
- Adhere to strict confidentiality in accordance with HIPAA requirements and proprietary company policies and procedures
Associate’s degree or its equivalent in experience required / Bachelor’s degree in Business Administration or related field preferred
A minimum of five (5) years experience in a business environment, preferably in the Healthcare industry
2-4 years of experience with Quality auditing processes or in a related area
2-4 years of experience in billing and/or accounting fields preferred
2-4 years prior supervisory/team leader experience preferred
Training experience preferred
Additional Relevant Experience/Education Required:
- PC Experience (MS Word and Excel) required
- Knowledge of Compuvision voucher processing and billing functions preferred
- Experience and working knowledge of CPT/HCPCS codes
- Quality review experience preferred
- 2-4 years professional office experience
Training Requirements (where applicable)
- Work changing schedules to meet business demands
- Work inside location
- Strong organization skills
- Speak clearly and effectively
- Calculate and manipulate numbers/data
- Read English
- Problem solve, reason and resolve issues effectively
- Meet customer expectations
- Work under stress with interruptions and deadlines
- Follow procedures and instructions
- Use computer effectively and view computer screen
- Wear protective eyewear and gloves
- Work with substances which may cause skin irritation and/or noxious fumes
- Exposure to temperature changes
- Bend and stoop continuously
- Reach above shoulder continuously
- Drive automatic equipment/vehicle never
Physical Demands/Work Environment:
- Complete all company training requirements within required time frames
- Cross training in all departments as needed
The physical demands described here are representative of those that must be met by an associate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions. The noise level in this location is moderate (use of computers, printers and machines).
Amount of Time
1/3 to 2/3
Use hands to touch, handle, or feel
Reach with Hands and Arms
Climb or balance
Stoop, kneel, crouch, or crawl
Talk or hear
- Must be detail orientated and well organized.
- Must be able to communicate clearly and effectively with other associates and clients.
- Must be energetic and self-motivated.
- Must be a team player.
- Must be able to problem solve.
Davis Vision Incorporated - 17 months ago