Job Summary

A Quality Analyst, working within the Advantum Process Improvement team, is responsible for monitoring compliance with billing rules/regulations by conducting reviews/audits of completed work files, educating professionals about workflow, process, documentation, and best practices; and recommending appropriate corrective actions surrounding revenue cycle services.  Ensuring quality and integrity in the revenue cycle is key in this role.


  • Life science Graduate or Post Graduate from a recognized educational institute.
  • Must be certified (CPC/COC).


Required Competencies

  • Candidate must have minimum 5 years of experience in medical coding, and minimum 1 year of experience in medical coding audit.
  • Good and expertise knowledge in multiple specialty of coding (E&M coding, Surgery and HCC.)
  • Good Knowledge of medical terminology.
  • Knowledge of Medicare and Medicaid billing rules required.
  • Knowledge of clinical workflow.
  • Process improvement mindset and ability to impact change is a must.
  • Good analytical skills and proficiency with MS Word, Excel and PowerPoint.
  • Excellent written & verbal communication skills.


Job Description

  • Performing daily audits of coding team and sending audit report on daily basis.
  • Providing effective and constructive feedback to the associates and to help in improving their performance.
  • Displaying cool and composed attitude during rebuttals and discussions.
  • Meet daily with Team leaders/Supervisor and teammates to review previous day quality results
  • Highlight potential issues in the operations to management.
  • Weekly review with supervisors.
  • Work closely with new hires, anyone new to a process, or having difficulty with errors to ensure quality work delivery in the future.
  • Trending errors to determine training opportunities.
  • May provide small group or one-on-one training/cross-training.
  • Develop recommendations for corrective action based on quality issues.
  • Maintains current knowledge of Advantum Health policies and guidelines related to documentation, coding, billing, revenue cycle, and as assigned, other professional integrity topics.
  • Develops or assists in developing training materials. Participates in a positive, helpful, manner at Quality staff meetings and at other Advantum Health meetings as assigned.
  • Taking initiatives to improve process and quality mechanism


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