About this role
Job title: Quality Analyst
About the Role The Quality Analyst will conduct quality audits on inpatient and observation accounts requiring Notification on Admission (NOA), ensuring accurate submission of notifications and timely initiation of non-clinical authorizations. This role supports ongoing process improvements and governance through data-driven insights.
What You'll Do
- Conduct quality audits on inpatient and observation accounts requiring NOA, in line with sampling guidelines.
- Validate accurate submission of notifications through portals, EDI, fax, or calls, and ensure timely initiation of non-clinical authorizations.
- Review documentation accuracy, including reference numbers, authorization numbers, payer timelines, and compliance requirements.
- Perform root cause analysis on identified defects, develop CAPA plans, and track recurring trends such as missed NOAs, delays, and documentation gaps.
- Provide actionable feedback on audit findings, support process clarifications, lead performance improvement discussions, and participate in periodic team reviews.
- Prepare daily, weekly, and monthly quality reports, track SLA and accuracy metrics, and contribute to governance reviews.