Vendor QA Analyst, Authorization

4 weeks ago

Downers Grove Illinois, United States Duly Health and Care Full time
Overview:
Good enough isn't for us. Duly Health and Care's team members show up every day driven to exceed expectations. We challenge assumptions and invite dissent to accomplish bold goals and unleash the most extraordinary work of your career. We see and support the remarkable in every person within and beyond the walls of our work.

 

Duly Health and Care works to understand what matters most to you. We recruit and retain team members who share a relentless passion and pride for helping others live happier and healthier lives. We invest in helping our team members develop their talents in a way that is rich in personal meaning. We invite you to join us, fulfill your purpose and make your mark

 

Holistic benefits designed to help our team members flourish in all aspects of their lives, including: 

Comprehensive medical and prescription drug benefits that include medical coverage at 100% (after deductible) when utilizing a Duly provider.

$5,250 Tuition Reimbursement per year. 

40 hours paid volunteer time off. 

A culture committed to Diversity, Equity, and Inclusion (DEI) and Social Impact

12 Weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members. 

401(k) Match

Profit-sharing program 

Are you ready to challenge the expected to deliver the extraordinary?

The QA Analyst for Authorization will coordinate, train, optimize and perform QA on the day-to-day activities of vendor management process.  Based on the observations from quality audit identify training needs and work with vendors to create curriculum and optimize existing training documents. This position will facilitate training and quality review within the Authorization Department of Duly Revenue Cycle Management.  This position trains, implements, monitors procedures/processes for maximum efficiency, productivity, and cost containment.  Ensures internal procedures for all areas are in compliance with contractual standards, industry standards, and accepted guidelines of regulatory agencies.    

Responsibilities:
The Journeys and Adventures that Await:

MAJOR RESPONSIBILITIES

Monitor vendor performance against service level agreements (SLAs) and key performance indicators (KPIs) to ensure they meet operational and compliance standards. (25%)

Perform quality control reviews to monitor the accuracy and timeliness of HPS authorization. (25%)

Based upon observations from quality audits, identify training needs and collaborate to train internal clinical operational areas and vendor teams, such as billing, coding, and patient care, to integrate the authorization services smoothly into the overall RCM process. (15%)

Identify and resolve issues related to vendor performance and HPS authorization processes. (15%)

Drive continuous improvement initiatives with vendors to enhance service delivery and patient outcomes. (10%)

Develop and maintain strong relationships with external vendors specializing in the HPS authorization services. (5%)

Facilitate regular reviews and audits to ensure adherence to healthcare regulations and standards, including HIPAA. (5%)

Stay updated with changes in healthcare regulations and industry best practices to ensure vendor services remain compliant and effective.

Performs other duties as necessary

Qualifications:
The Experience You Bring:

 

MINIMUM EDUCATION AND EXPERIENCE REQUIRED

Level of Education: 5 years or more of experience in i the Registration, Eligibility & Benefit Estimation Healthcare field for large multi-specialty group practice.  Training/QA background preferable.

 

Years of Experience: 5+ years

 

Describe Type of Experience

 

MINIMUM KNOWLEDGE, SKILLS, AND ABILITIES 

Strong understanding of healthcare processes, especially patient registration, eligibility, benefit estimation and compliance requirements.

Excellent training and relationship management skills.

Strong analytical and problem-solving abilities.

Exceptional communication and interpersonal skills.

Proficiency in healthcare IT systems and software.

Desirable Experience:

Experience with electronic health records (EHR) systems-preferably Epic

  • Vendor Trainer-qa Analyst, Registration

    1 month ago

    Downers Grove, United States Duly Health and Care Full time

    Overview: - Good enough isn't for us. Duly Health and Care's team members show up every day driven to exceed expectations. We challenge assumptions and invite dissent to accomplish bold goals and unleash the most extraordinary work of your career. We see and support the remarkable in every person within and beyond the walls of our work._ - Duly Health and...

  • Vendor Mgr, Authorization Mgt

    1 month ago

    Downers Grove, United States Duly Health and Care Full time

    Overview: **Hours**: Monday through Friday, 8am-5pm **Location**: Downers Grove, IL (Hybrid) - Good enough isn’t for us. Duly Health and Care’s team members show up every day driven to exceed expectations. We see and support the remarkable in every person within and beyond the walls of our work._ - Duly Health and Care works to understand what matters...

  • Vendor Mgr, Registration

    1 month ago

    Downers Grove, United States Duly Health and Care Full time

    Overview: **Hours**: Monday through Friday, 8am-5pm **Location**: Remote - Good enough isn’t for us. Duly Health and Care’s team members show up every day driven to exceed expectations. We see and support the remarkable in every person within and beyond the walls of our work._ - Duly Health and Care works to understand what matters most to you. We...

  • Senior Benefits Analyst

    2 weeks ago

    Downers Grove, United States Univar Full time

    Select how often (in days) to receive an alert: Create Alert Start your career journey with Univar Solutions! Here you can make an impact on the world around you and accelerate your career in areas that energize and excite you. Senior Benefits Analyst: The Senior Benefits Analyst will be responsible for the administration and management of assigned benefit...

  • Senior Benefits Analyst

    7 hours ago

    Downers Grove, United States Univar Full time

    Select how often (in days) to receive an alert: Create Alert Start your career journey with Univar Solutions! Here you can make an impact on the world around you and accelerate your career in areas that energize and excite you. Senior Benefits Analyst: The Senior Benefits Analyst will be responsible for the administration and management of assigned benefit...

  • Senior Benefits Analyst

    2 weeks ago

    Downers Grove, Illinois, United States Univar Solutions USA Inc Full time

    A Place Where People Matter. Start your career journey with Univar Solutions Here you can make an impact on the world around you and accelerate your career in areas that energize and excite you.Senior Benefits Analyst:The Senior Benefits Analyst will be responsible for the administration and management of assigned benefit plans. This includes ensuring...

  • Senior Benefits Analyst

    2 days ago

    Downers Grove, Illinois, United States Univar Solutions USA Inc Full time

    A Place Where People Matter. Start your career journey with Univar Solutions Here you can make an impact on the world around you and accelerate your career in areas that energize and excite you.Senior Benefits Analyst:The Senior Benefits Analyst will be responsible for the administration and management of assigned benefit plans. This includes ensuring...

  • Talent Acquisition Excellence Analyst

    6 days ago

    Downers Grove, United States Fresenius Medical Care Full time

    PURPOSE AND SCOPE: The Talent Acquisition Excellence Analyst will support the development, implementation, and maintenance of recruiting technologies and processes in support of the Global Talent Acquisition function. They will drive content creation for all Talent Acquisition process and training. They will simultaneously engage in various cross-functional...

  • Strategic Sourcing Analyst

    1 day ago

    Downers Grove, United States TEKsystems Full time

    Strategic Sourcing AnalystHybrid Position in Downers Grove, IL Top Skills Details:Strategic SourcingProcurement Analysis work pertaining to contracts Reporting of KPI'sDescription:Our customer is seeking to hire a Strategic Sourcing Analyst. This role will be working alongside a team of 1 other analyst, but the overall procurement organization is roughly a...

  • NOC Analyst

    2 weeks ago

    Downers Grove, United States Sentinel Offender Services Full time

    Responsibilities Sentinel is seeking an NOC Analyst to join our team. This is an excellent opportunity to join a premier company and grow your career. Network Analysts are at the heart of what makes Sentinel succeed. As a member of this nationally recognized team, you will be fielding calls from our book of customers and helping them stay up and running in...

  • NOC Analyst

    1 day ago

    Downers Grove, United States Sentinel Offender Services Full time

    Responsibilities Sentinel is seeking an NOC Analyst to join our team. This is an excellent opportunity to join a premier company and grow your career. Network Analysts are at the heart of what makes Sentinel succeed. As a member of this nationally recognized team, you will be fielding calls from our book of customers and helping them stay up and running in...

  • Strategic Sourcing Analyst

    1 day ago

    Downers Grove, United States TEKsystems Full time

    Strategic Sourcing Analyst Hybrid Position in Downers Grove, IL Top Skills Details: Strategic Sourcing Procurement Analysis work pertaining to contracts Reporting of KPI's Description: Our customer is seeking to hire a Strategic Sourcing Analyst. This role will be working alongside a team of 1 other analyst, but the overall procurement...

  • Jd Edwards Business Analyst

    1 week ago

    Downers Grove, United States Silgan Containers Mfg Corp Full time

    JD Edwards IT Business Analyst What we can offer you: - A great culture where you are like a member of our family - achievements are recognized, acknowledged and celebrated. - Competitive salary & comprehensive benefits including health, dental, vision, life, short & long-term disability, critical care, AD&D, dependent life. - Add-on benefits include pet...

  • Senior Treasury Analyst

    1 week ago

    Downers Grove, Illinois, United States Univar Solutions USA Inc Full time

    A Place Where People Matter. Start your career journey with Univar Solutions Here you can make an impact on the world around you and accelerate your career in areas that energize and excite you.Senior Treasury Analyst:The Senior Treasury Analyst will be a key member of Treasury, and will provide the analytical support for several key Treasury processes...

  • Senior Treasury Analyst

    2 days ago

    Downers Grove, Illinois, United States Univar Solutions USA Inc Full time

    A Place Where People Matter. Start your career journey with Univar Solutions Here you can make an impact on the world around you and accelerate your career in areas that energize and excite you.Senior Treasury Analyst:The Senior Treasury Analyst will be a key member of Treasury, and will provide the analytical support for several key Treasury processes...

  • IT Business Systems Analyst II

    1 month ago

    Downers Grove, United States Flavorchem Corporation Full time

    The IT Business Systems Analyst (BSA) will help solve business/system challenges through leading discovery, information gathering and data analysis efforts. The BSA plays a critical role in developing business requirements, configuring, building, testing, certifying, installing, and maintaining all changes and modifications to supported applications,...

  • IT Business Systems Analyst II

    2 months ago

    Downers Grove, United States Flavorchem Corporation Full time

    The IT Business Systems Analyst (BSA) will help solve business/system challenges through leading discovery, information gathering and data analysis efforts. The BSA plays a critical role in developing business requirements, configuring, building, testing, certifying, installing, and maintaining all changes and modifications to supported applications,...

  • IT Business Systems Analyst II

    1 month ago

    Downers Grove, United States Flavorchem Corporation Full time

    The IT Business Systems Analyst (BSA) will help solve business/system challenges through leading discovery, information gathering and data analysis efforts. The BSA plays a critical role in developing business requirements, configuring, building, testing, certifying, installing, and maintaining all changes and modifications to supported applications,...

  • Indirect Sourcing Analyst

    1 month ago

    Downers Grove, United States Zurn Elkay Water Solutions Full time

    Indirect Sourcing Analyst (Manufacturing Category)The CompanyZurn Elkay Water Solutions Corporation is a thriving, values-driven company focused on doing the right things. We're a fast growing, publicly traded company (NYSE: ZWS), with an enduring reputation for integrity, giving back, and providing an engaging, inclusive environment where careers flourish...

  • Indirect Sourcing Analyst

    2 days ago

    Downers Grove, United States Zurn Elkay Water Solutions Full time

    Indirect Sourcing Analyst (Manufacturing Category)The CompanyZurn Elkay Water Solutions Corporation is a thriving, values-driven company focused on doing the right things. We're a fast growing, publicly traded company (NYSE: ZWS), with an enduring reputation for integrity, giving back, and providing an engaging, inclusive environment where careers flourish...