Quality Improvement Analyst

Yale University

New Haven, Connecticut, US
Base: $90,000.00 - $165,750.00; bonus/equity: not ...
Fully remote
Working knowledge of medical terminologies and coding
Proven experience in a claim's environment
Understanding of hipaa confidentiality laws
Yale University is seeking a Quality Improvement Analyst to work remotely, focusing on ensuring accurate claims processing and network compliance within its health services department. The ideal candidate will possess a strong background in claims adjudication and auditing, along with excellent analytical and communication skills

Job Summary

  • Yale Health is seeking a Quality Improvement Analyst to collaborate with operational leaders on accurate claims processing and network compliance.
  • The role involves auditing system configurations against provider contract requirements and identifying fee schedule discrepancies.
  • This is a full-time remote position requiring a Bachelor's degree and at least 5 years of advanced claims adjudication experience.

Matching Summary

Match Score: 85

Yale University is seeking a Quality Improvement Analyst to work remotely, focusing on ensuring accurate claims processing and network compliance within its health services department. The ideal candidate will possess a strong background in claims adjudication and auditing, along with excellent analytical and communication skills.

Salary

Base: $90,000.00 - $165,750.00; Bonus/Equity: Not specified; Benefits: Not specified

Skills & Requirements

Must-have

  • Working knowledge of medical terminologies and coding
  • Proven experience in a claim's environment
  • Understanding of HIPAA Confidentiality laws
  • Experience building and running SQL queries
  • Minimum 5 years advanced claims adjudication experience

Nice-to-have

  • Excellent written and oral communication skills
  • Strong analytical aptitudes and problem-solving
  • Enthusiastic attitude and cooperative team player
  • Demonstrated ability to adapt to changing circumstances
  • Experience with Microsoft Office suite

Key Requirements

  • Bachelor's degree required
  • Minimum 5 years advanced claims adjudication experience
  • Minimum 3 years experience auditing claims adjudication
  • Facility, professional, and ancillary claims experience
  • HIPAA confidentiality law understanding

Work Rights

Not specified

Tailored Resume

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