The Quality Analyst/Claims will review claims for both new hires and experienced examiners and claim adjusters in a timely and consistent manner, and generate accuracy reports per examiner to be reviewed by Supervisor, and senior management. Responsibilities also include the review and auditing of the Provider Communication, Provider Fee Schedule and Provider Database team. Quality Analyst will be responsible for auditing, training, and some reporting functions.
High school Graduate or GED equivalent
Minimum five years experience claims adjudication, a minimum two years auditing experience
Equipment Operated: PC, 10 key skills, medical coding, CPT and HCPC coding.
Exceptional Verbal (e.g., Public Speaking)
Writing /Composing/ (Correspondence / Reports)
Analytical, Medical Terms, Research, P.C.
Knowledge of ICD-9 coding, HCPCS, and CPT codes.
Good Interpersonal skills.
Internal Number: 146429
About Harris Health System
The Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes 23 community health centers, five school-based clinics, a dental center and dialysis center, mobile health units, a rehabilitation and specialty hospital and two full-service hospitals.Ben Taub Hospital is a world renowned Level I Trauma Center with 586 licensed acute-care beds and provides a wide range of specialty care outpatient services. Lyndon B. Johnson Hospital is a 328 licensed bed acute-care hospital with a newly expanded Level III trauma center and a distinguished regional center for neonatal intensive care for high-risk deliveries.Harris Health is a teaching system for Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth). We train the next generation of healthcare providers on the latest medical procedures and technological breakthroughs.With... our fully integrated electronic medical records system, we offer patients the convenience and assurance that their medical history is accurate, safe and available when and where it is needed. Our Medical Home designation ensures that we offer a full range of preventive, specialty and acute care services for the entire family.