Our Ability Jobs

Quality Review and Audit Analyst

job details:

• location:Nashville, TN

• salary:$17 - $22 per hour

• date posted:Tuesday, February 23, 2021

• experience:Entry Level

• job type:Temporary

• reference:AB_3577527

• questions:hemant.baradwaz@randstadusa.com646-710-3262

job description

Quality Review and Audit Analyst

Knowledge/Skills Required • BA/BS or equivalent work experience • Knowledge of Medicare or Managed care experience • High attention to detail, quality and accuracy strong computer skills required (Microsoft Office Suite products preferred) • Excellent listening, written and verbal communication skills required • Adaptable, flexible, and able to manage through change in a fast-paced environment

Responsibilities

• Performs monitoring of internal partners, external partners (70+ FDRs with 1,400 down-lines and 20,000 agents)

• Provides feedback to agents and managers as well as external partners regarding agent/agency performance and compliance.

• Maintains a strong rapport with telephonic internal and external partners

• May be directly involved in complex operational audits and monitoring or regulatory inquiries to provide expertise and guidance on technical or procedural issues

• Performs annual audit of CMS’ Foreign Language-TTY study to ensure that agents adhere to guidelines enforced by CMS

• Performs ad hoc review of data to improve processes and develop remediation as necessary

• Ensures CMS and Cigna audit readiness

• Ensures that external partners adhere to filed telephonic scripts

Skills

• Quality Assurance

Education

• High School (required)

Qualifications

• Years of experience: 1 year

• Experience level:Entry Level

Shift: First

Working hours: 8 AM - 5 PM

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