Quality Assurance Manager
5 days ago
The Quality Assurance Manager at HGS Offshore Staffing Solutions is responsible for ensuring the highest quality standards are met across all client portfolios. This role involves working closely with offshore and training managers to implement quality-related processes, conduct quality audits, and analyze data to improve quality outcomes.
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.
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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