Quality Improvement Analyst

Yale Health

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 Health is seeking a Quality Improvement Analyst to enhance claims processing and network compliance in a fully remote role. The ideal candidate will have extensive experience in claim adjudication, strong analytical skills, and the ability to collaborate with operational leaders. The position offers a competitive salary range and the opportunity to contribute to health services for a diverse community

Job Summary

  • Yale Health is seeking a Quality Improvement Analyst to collaborate with operational leaders to ensure accurate claims processing and network compliance.
  • This remote position involves auditing system configurations against provider contract requirements and identifying fee schedule discrepancies.
  • The role requires a Bachelor's degree and at least five years of advanced claims adjudication experience including facility, professional, and ancillary claims.

Matching Summary

Match Score: 85

Yale Health is seeking a Quality Improvement Analyst to enhance claims processing and network compliance in a fully remote role. The ideal candidate will have extensive experience in claim adjudication, strong analytical skills, and the ability to collaborate with operational leaders. The position offers a competitive salary range and the opportunity to contribute to health services for a diverse community.

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
  • Minimum 3 years experience auditing claims adjudication

Nice-to-have

  • Excellent written and oral communication skills
  • Strong analytical aptitudes and problem-solving skills
  • Enthusiastic attitude and cooperative team player
  • Ability to adapt to new or changing circumstances
  • Demonstrated ability to prioritize tasks effectively

Key Requirements

  • Bachelor's degree required
  • Minimum 5 years advanced claims adjudication experience
  • Minimum 3 years experience auditing claims adjudication
  • Subject to pre-employment background screening
  • Must meet healthcare worker health requirements

Work Rights

Not specified

Tailored Resume

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