Hiring.Camp

Quality Review & Audit Analyst

Sagility

·

Today

Location
Quezon City, Bridgetowne GBF Center 1, Philippines
Workplace
Onsite
Type
Full-time
Department
Finance
Education
High School
Closing date
Today
Source
Workday

Description

Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.

As a Quality Review and Audit Analyst you will work with varied members of leadership and clients and will serve as the point of contact for all quality related concerns. You will utilize your technical expertise to identify opportunities to streamline processes and/or adherence to SOPs or processes.  The role will require strong analytical and facilitation skills for presentation purposes. Excellent communication skills and the ability to influence are key.

Job title:

Quality Review & Audit Analyst

Job Description:

Education :

  • High School Diploma or G.E.D. required

  • Six-Sigma green belt training helpful

Experience:

  • 2+ years’ customer service experience required

  • Previous experience with high quality performance and review parameter

  • Working knowledge of Microsoft Office applications

Mandatory Skills:

  • Excellent organizational and planning skills

  • Excellent written and oral communication skills

  • Excellent interpersonal skills and professionalism

Preferred Skills:

  • Experience analyzing and interpreting data and recommending solutions

  • Strong analytical and organizational skills preferred

  • Detail oriented

  • Ability to manage multiple priorities and deadlines

  • Excellent communication skills, both written and verbal

  • Ability to function in a production environment while maintaining high quality results

  • Ability to make sound, independent judgments and decisions

  • Ability to influence others through the use of data

  • Experience analyzing and interpreting data and recommending solutions

  • Strong analytical and organizational skills preferred

  • Detail oriented

  • Ability to manage multiple priorities and deadlines

  • Excellent communication skills, both written and verbal

  • Ability to function in a production environment while maintaining high quality results

  • Ability to make sound, independent judgments and decisions

  • Ability to influence others through the use of data

Roles & responsibilities :

  • Review calls, emails, and chats for accuracy and identify opportunities analyze trends from call listening sessions, Identify and recommend improvements in processing and procedures and assist in the development of audit guidelines

  • Act as a subject matter expert and a resource for team members

  • Actively engage in quality initiatives to address error trends and process improvement

  • Facilitate national and site level calibrations and client calibrations,

  • Use various tools, methods and information sources to create analyses that identify any customer service deficiencies

  • Utilize the results of the above analyses to champion and coordinate remediation or proactive initiatives to improve quality

  • Serve as SME for technical questions and works to ensure standards are being met

  • Represent the team in internal and external audits

  • Drive the success of quality performance by identifying key opportunities to improve process flows and recognizing potential knowledge gaps at the individual/site level

  • Assess problems with client or systemic processes to mitigate any impact to our members.

  • Observe Supervisors’ scoring and provide findings to ensure scoring consistency

  • Conduct test calls, focus groups, and targeted audits or call monitors as necessary to identify trends and opportunities for quality improvements in a complete, accurate, and timely manner.

Location:

Quezon City, Bridgetowne GBF Center 1Philippines

Skills

Customer Service

Similar Jobs

30

Quality Review & Audit Analyst

Sagility · Quezon City, Bridgetowne GBF Center 1, Philippines · Onsite

Today

Quality Review & Audit Analyst

Sagility · Quezon City, Bridgetowne GBF Center 1, Philippines · Onsite

Today

Senior Manager - Liquidation Quality Review

Arendt · Arendt 9, Luxembourg

Yesterday

Quality Review RN : Hospice

Hoag Memorial Hospital Presbyterian · Newport Beach, CA, United States, US

4 days ago

Quality Review Specialist (GMP / Batch Record / DHR) (m/w/d), befristet

Thermofisher · Germany - Freiburg - Munzinger Str. 7 · Onsite

1 week ago

Director, Pre-Bill DRG Review - Quality Assurance, Training & Education

Corrohealth · NJ-Remote, United States of America · Remote

1 week ago

Claims Quality Review Sr Consltant

Cna · US- CO07- Littleton-10375 Park, United States of America +44 · Hybrid

1 week ago

Annual Product Quality Review Program Lead

Tris Pharma · Monmouth Junction, NJ

1 week ago

Quality Review and Audit Senior Representative

Cigna · IND Bengaluru, India · Onsite

1 week ago

Quality Review (LVN) : Home Health

Hoag Memorial Hospital Presbyterian · Newport Beach, CA, United States, US

2 weeks ago

Manager, Coding Quality Review (Remote)

Adventist Health · Roseville, CA, United States, US

2 weeks ago

Quality Review/Audit

Cigna · MYS Kuala Lumpur, Malaysia · Hybrid

3 weeks ago

Operations Quality Review Specialist/PT 30 hours/ Onsite Nashua

Triangle Credit Union · Nashua, NH

3 weeks ago

Operations Quality Review Specialist/PT 30 hours/ Onsite Nashua

Triangle Credit Union · Nashua, NH

3 weeks ago

Case Setup Specialist (Data Entry & Quality Review)

Verticalscreen · Warminster, PA, US · Onsite

1 month ago

Acute Coding Quality Review Auditor (Remote)

Adventist Health · Roseville, CA, United States, US

1 month ago

Quality Review Specialist III

Qlarant · REMOTE, FL · Remote

1 month ago

Quality Review and Audit Supervisor

Cigna · MYS Kuala Lumpur, Malaysia · Hybrid

1 month ago

Senior Specialist, KYC Review & Quality Control

0101022-GIA PROD US LOS ANGELES · Singapore, Singapore, Singapore, SG

1 month ago

Quality Review & Reporting Senior Analyst

Cw · Budapest, Hungary · Hybrid

1 month ago

Quality Review Specialist I (MCS)

Stewart is on · USA TX - Remote, United States of America · Remote

1 month ago

Provider Quality Review Nurse, RN

Iehp · Rancho Cucamonga, CA, US

2 months ago

Supervisor, Clinical Quality Review

Medica · Minnetonka +3

3 months ago

Sterile Processing Quality Review Tech Mid Shift

Nshs · EMH Main Hospital Elmhurst, United States of America +4

5 months ago

Credentialed Inpatient Auditor (Coding Quality Review / Educator) WFH (OK, TX, AR, KS, MO)

Oumedicine · WFH State of Oklahoma, United States of America +4 · Remote

5 months ago

Manager – SEAPEN CoE Audit quality review

Pwc · Kuala Lumpur Office, Malaysia

6 months ago

QUALITY REVIEW EXECUTIVE

Omega External Career Portal · Manila Rizal, Philippines

10 months ago

QUALITY REVIEW EXECUTIVE

Omega External Career Portal · CEBU, Philippines

1+ year ago

QUALITY REVIEW EXECUTIVE

Omega External Career Portal · CEBU, Philippines

1+ year ago

Human Services Quality and Review Specialist (with Special Skills Classes)

Sacramento County · Sacramento, CA, CA, US

1 week ago
Quality Review & Audit Analyst at Sagility | Hiring.Camp