Training and Quality Analyst

1 week ago


Taguig, National Capital Region, Philippines HGS Offshore Staffing Solutions Full time

Summary:

The Training and Quality Analyst is responsible for training and quality analysis, working closely with both onshore and offshore managers to ensure high training and quality standards for assigned portfolios/teams. This role involves identifying process gaps, conducting training, and ensuring compliance with quality expectations.

Key Responsibilities:

  • Develop expertise in claims management across assigned portfolios.
  • Analyze training and quality needs to identify and address process and educational gaps.
  • Conduct new hire and refresher training, including assessments.
  • Create an engaging learning environment suited to various learning styles.
  • Serve as a subject matter expert, supporting team members in meeting quality expectations.
  • Meet individual productivity and audit goals on a weekly basis.
  • Assist offshore and training managers in implementing training and quality-related processes.
  • Develop and maintain training materials, including presentations and process guides.
  • Conduct quality calibrations to align team members with quality and process standards.
  • Collaborate with portfolio managers to address quality gaps and improvement opportunities.
  • Perform quality audits, analyze data, and strategize with managers to improve quality outcomes.

Skills and Qualifications:

  • Previous experience in a training and quality role, preferably in a healthcare or claims management setting.
  • Extensive knowledge of Commercial and Government Insurance plans, eligibility, and medical billing.
  • Strong understanding of HIPAA, PHI guidelines, CPT, ICD-10, UB, HCFA, and 837 terminologies.
  • Excellent interpersonal and customer service skills.
  • Strong attention to detail, problem-solving, and analytical skills.
  • Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint).
  • Familiarity with Google Suite (Google Drive, Sheets, etc.).
  • Excellent verbal and written communication skills.
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