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Process Quality Control Associate
1 week ago
Job Summary:
The Business Process Associate III plays a critical role in ensuring the accuracy and efficiency of our business processes. As a key member of our team, you will be responsible for reviewing and analyzing medical and financial information to ensure compliance with standard procedures.
Responsibilities:
Medical Information Review:
- Enter medical and bill information into our system
- Verify data for accuracy and completeness
- Process client information
- Analyze medical information for appropriateness
- Prepare reports as necessary
- Conduct quality assurance on processes and documents
- Coordinate medical treatment schedules with stakeholders
- Approve payments of medical bills
- Collaborate with onshore partners to resolve and close claims
Finance Information Review:
- Act as the point of contact in the absence of a Team Lead or Supervisor
- Handle complex scenarios requiring further analysis and decision making
- Process client information
- Ensure the accuracy of financial data provided internally and externally
- Prepare reports as necessary
- Conduct quality assurance on processes and documents
- Facilitate additional training needed by the team
Business Process Support:
- Analyze and resolve issues and inquiries regarding work matters
- Route tasks to appropriate processors using internal systems
- Refer matters beyond limits of authority and expertise to immediate superior
- Protect information confidentiality according to the Crawford Code of Conduct
- Adhere to standard operating procedures and turnaround time set by the company
- Perform administrative duties and other related tasks assigned to contribute to business processes
Requirements:
- Bachelor's degree in any related field
- At least two years related work experience
- Must have:
- Proficient typing skills
- Good communication skills
- Proficient in word processing and spreadsheet software
- High analytical skills in reviewing medical information or financial information
- Desired:
- Competence in case management outcomes
- Knowledge and understanding of QI and QA practices
- Ability to multi-task, prioritize, and manage time effectively
- Keen attention to detail to produce quality output
- Maintains a high degree of professionalism and confidentiality
- Interpersonal skills - able to work independently and as a team member