Quality Auditor (DME)

Roles and Responsibilities:

• Strong interpersonal and communication skills.
• Strong attention to details to identify, record and prioritize issues.
• Troubleshooting to present viable solutions as problems arise.
• Solid report writing skills and command of written communication.
• Review and evaluate claim management work, including claim submissions, resubmissions, and appeals, to ensure compliance with industry regulations, payer guidelines, and company policies.
• Develop and implement quality assurance processes, including regular audits, to identify areas for improvement and ensure the accuracy of the Team's work.
• Collaborate with the Team and other departments, such as billing and coding, to address claim errors and streamline the processes.
• Monitor and track trends and team performance metrics, providing regular reports to the Team Lead and recommending strategies for improvement.
• Stay up to date with industry regulations, payer guidelines, and best practices in RCM, and provide ongoing training and updates to the team.
• Assist the Team Lead in fostering a positive and collaborative work environment that encourages continuous learning and development.
• Willing to work in the night shift / US timings.