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Corp Managed Svcs RCMS - Associate Quality Control- Operate
2-4 years
Hyderabad / Secunderabad
1 vacancy
Corp Managed Svcs RCMS - Associate Quality Control- Operate
PwC
posted 1mon ago
Job Role Insights
Flexible timing
Key skills for the job
Job Description
A career in our Managed Services team will give you an opportunity to collaborate with many teams to help our clients implement and operate new capabilities, achieve operational efficiencies, and harness the power of technology
Our Revenue Cycle Managed Services team will provide you with the opportunity to act as an extension of our healthcare clients revenue cycle functions
We specialize in front, middle and backoffice revenue cycle functions for hospitals, medical groups, and other providers
We leverage our custom and automated workflow and quality assurance products to enable our clients
Our Revenue Cycle Managed Services team will provide you with the opportunity to act as an extension of our healthcare clients revenue cycle functions
We specialize in front, middle and backoffice revenue cycle functions for hospitals, medical groups, and other providers
We leverage our custom and automated workflow and quality assurance products to enable our clients
to achieve better results, which ultimately allows them to provide better patient care
Minimum Degree Required (BQ) *
Bachelor s Degree
Degree Preferred
Bachelor s Degree
Required Field(s) of Study (BQ)
Computer Science, Data Analytics, Accounting
Preferred Field(s) of Study
Minimum Year(s) of Experience (BQ) * US
2 year s of experience
Certification(s) Preferred
Required Knowledge/Skills (BQ)
Preferred Knowledge/Skills *
The quality control analyst conducts quality control audits of patient accounts referred to the Revenue Cycle Managed Services (RCMS) and assures company and client standards are maintained and the integrity of client services are preserved
The Quality Control Analyst will perform a variety of functions including, but not limited to reviewing and monitoring accounts, identifying problems, analyzing trends and suggesting recommendations for improvements
This role consults with and takes direction from the Continuous Improvement Specialist to resolve quality and efficiency issues that may occur on any given project
The Quality Control Analyst will perform a variety of functions including, but not limited to reviewing and monitoring accounts, identifying problems, analyzing trends and suggesting recommendations for improvements
This role consults with and takes direction from the Continuous Improvement Specialist to resolve quality and efficiency issues that may occur on any given project
- Years of Experience 24 years is required in the following areasMedical collections (Medical Collections Specialist II preferred), billing and/or claims experience
- Customer service experience
- ll payer knowledge required (government and nongovernment)
Responsibilities
As Quality Control Analyst specific responsibilities include but are not limited to
- Performs quality control audits; reviews and monitors accounts
- Identifies problems, analyzes cause and effect, and suggests recommendations for improvement;
- Provides daily constructive feedback based on account notation;
- Identifies areas of weakness and communicates recommendations on changes and improvement to Continuous Improvement Specialists;
- Document findings of analysis
May prepare reports and suggests recommendations of implementation of new systems, procedures or organizational changes;
- Relies on specific instructions and preestablished guidelines to perform the functions of the job;
- Possesses ability to be confidential; Supports company compliance by demonstrating adherence to all relevant compliance policies and procedures; demonstrates knowledge of HIPAA Privacy and Security Regulations as evidenced by appropriate handling of sensitive information;
- Consults and collaborates with Continuous Improvement Specialist to identify and assess training needs based on work audited;
- Participate in quality control meetings;
- Possesses considerable leadership skills, fostering an atmosphere of trust; seeks diverse views to encourage improvement and innovation; coaches and develops staff through timely and meaningful written feedback;
- Possesses a cooperative and positive attitude toward management and coworkers by responding politely and professionally and being a valued team player; and,
- Exemplifies extensive knowledge of the hospital revenue cycle with specialization in healthcare billing, followup, and the account resolution process to include, but not limited to claims submission, acceptance, and adjudication, transaction reviews, adjustment posting, identification of patient responsibility, etc
Required Knowledge and Skills
- Good analytical and math sk ills
- Able t o document problems and assist in their re solution
- Demonstrated a bility exceeding all established department/client quality and productivity st andards;
- Proven a bility to lead by example and foster mentoring re lationships
- Strong w ritten and oral communication sk ills
- Computer a nd internet literate in an MS Office environment; an d,
- Ability t o establish and maintain effective working relationships
- US Healthcare Commercial and Managed Care Insurance Claim Management/Billing/Claim Edit Resolution
- US Healthcare Medicare and Medicaid Insurance Claim Management/Billing/Claim Edit Resolution
- US Healthcare Denials Management (technical and clinical)
- US Healthcare Underpayment/Payment Variance Management
- Experience Level 2 to 4 ye ars
- Shift t imings Flexible to work in night shifts (US Time zone)
- Preferred Qualification Bachelor s degree in finance or Any Graduate
Education (if blank, degree and/or field of study not specified)
Degrees/Field of Study required Certifications (if blank, certifications not specified)
Required Skills
Optional Skills
Accepting Feedback, Accepting Feedback, Active Listening, Automation Solutions, Business Process Improvement, Communication, Competitive Advantage, Cost Efficiency, Demand Management, Emerging Technologies, Emotional Regulation, Empathy, Inclusion, Intellectual Curiosity, Lean Process Improvement, Operating Model, Operational Analysis, Operational Excellence, Operational Support and Analysis, Operations Management, Operations Process Improvement, Operations Strategy, Operations Support, Optimism, Process Data Collection {+ 9 more} Available for Work Visa Sponsorship?
No Government Clearance Required?
No Employment Type: Full Time, Permanent
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Quality Control Associate salary at PwC
reported by
2
employees
with 6-7
years exp.
₹5.4
L/yr - ₹6.9
L/yr
11%
more
than the average Quality Control Associate Salary in India
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What PwC employees are saying about work life
based on 8.6k employees
Flexible timing
Monday to Friday
No travel
Day Shift
PwC Benefits
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