Quality Auditor - Claims Adjudication

Job Description

Job description Quality Auditor - Claims Adjudication Location : Navalur,Chennai Roles & Responsibilities: In-depth Knowledge and Experience in the US Health Care Payer System. 3-8 years of excellent knowledge on client specifics and experience in all types of Claims Adjudication. Good experience in Quality team handling. Perform quality review of claims based on the documentation provided by client to ensure claim output meets all customer specifications Collects all findings during the audits and perform effective root cause analysis along with examiners & ops supervisors Generate multiple level of analysis from the audit findings and identify opportunities to improve overall process Circulate quality dashboards at agreed periodic intervals to all relevant stake holders Conduct 1-0-1 coaching / feedback on specific error scenarios Provide suggestions to Trainer and Ops on the slow performers who needs additional coaching / re-training on specific areas Tracks all feedback from client and provide constructive information to agents during daily quality team huddle Participates in client knowledge calibration exercise Understanding Client P&Ps and auditing documents / claims based on instruction guidelines. Record audit findings and prepare audit reports and circulate quality dashboard Organize ILP review meeting and quality briefings to update associates on any quality issues Analyze internal/client feedback and respond with details Handling Feedback sessions efficiently. Interested Candidates share your CV - deepalakshmi.rrr@firstsource.com / 8637451071 Disclaimer: Firstsource follows a fair, transparent, and merit-based hiring process. We never ask for money at any stage. Beware of fraudulent offers and always verify through our official channels or deepalakshmi@firstsource.com email addresses.