Senior Analyst - ROI Quality

The Senior Analyst – ROI Quality will play a critical role in ensuring the accuracy and efficiency of the transactional processing within the organization. Required to work with the Quality Manager in designing the Quality Management System that standardizes and documents all processes. This position involves analyzing data, identifying trends, and implementing quality improvement initiatives related to ROI processing. The role also requires strong analytical and communication skills, as well as a deep understanding of insurance processes and relevant regulations.

Key Responsibilities:

• Quality Assurance: Monitoring and evaluating the quality of ROI processing activities, identifying errors, and recommending corrective actions.
• Data Analysis: Analyzing data to identify trends, patterns, and areas for improvement in the processing workflows.
• Process Improvement: Developing and implementing process improvements to enhance the efficiency and accuracy of the processing.
• Reporting and Documentation: Preparing reports on quality metrics, analyzing trends, and documenting findings for management review.
• Collaboration: Working with various teams, including logging, assigning, abstracting and IT, to resolve issues and implement quality initiatives.
• Training and Development: Providing training and guidance to team members on quality standards and best practices in healthcare data processing.
• Staying Updated: Staying informed about industry best practices, regulatory changes, and new technologies related to healthcare operations.
  
  
  

• Strong Analytical Skills: Ability to analyze complex data, identify trends, and develop solutions to improve quality.
• Healthcare Knowledge: Understanding of US healthcare processing, documents and key stakeholders, and the regulations (e.g., HIPAA).
• Communication Skills: Ability to communicate effectively with team members, stakeholders, and management. Also, should have good comprehension and English writing skills.
• Problem-Solving Skills: Ability to identify and resolve issues related to processing.
• Proficiency in MS Office Suite: Especially Excel for data analysis and reporting.
• Attention to Detail: Accuracy and thoroughness in reviewing and analyzing the data.
• Qualifications: Candidate must possess at least a Bachelors/College Degree in any field or equivalent. Must have at least 5+ years of work experience in Quality.