We are seeking a highly motivated and quantitative-oriented Quality Assurance Lead to join our growing BPO team. You will be part of the Data Enrichment Healthcare Credentialing Team as a Quality Assurance Lead. You will be responsible for ensuring that our organization meets all credentialing and quality standards in healthcare. The QA Lead will perform a range of duties, including reviewing and analyzing credentialing files and applications, ensuring compliance with regulatory requirements, and monitoring the ongoing performance of QA Team.
Bold Business is a US-based leading global business processing outsourcing firm with over 25 years experience and $7B+ in client engagements. We enable small and publicly traded businesses to scale by providing global outsourcing talent services.
Key Responsibilities:
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Review and analyze healthcare provider credentialing applications, files, and supporting documents to ensure accuracy and completeness
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Verify that all healthcare providers have current and valid licenses and certifications, and meet all regulatory and accrediting agency requirements
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Conduct ongoing monitoring and audits of healthcare providers to ensure compliance with credentialing and quality standards
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Provide support and guidance to QA Team on credentialing and quality-related matters
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Collaborate with internal teams to develop and implement credentialing and quality assurance policies and procedures
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Maintain accurate and up-to-date credentialing and quality assurance records and documentation
- Implement quality management plan for healthcare provider credentialing, including quality scorecards, performance monitoring, calibration, quality analysis and insights, reporting, and process improvement.
- Serve as the central point of contact for quality needs in the projects supported to ensure client's expectations are met
- Participate in external audits and surveys related to credentialing and quality assurance
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Provide regular reports and analysis on credentialing and quality assurance performance Metric
Qualifications:
- Minimum of 3 years of experience as a QA Lead in the BPO industry
- Work from Home set up
- Excellent coaching skills and attention to detail
- Analytical and has a great command of the English language
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