Team Lead - Quality (Prior Auth)

Job Responsibilities

• Should possess a complete knowledge and understanding of AR/Pre Auth process, software and Quality guidelines of the clients program assigned.
• Random Transactional Monitoring – Ensuring systematic Quality check of previous day’s production i.e. Analysis of account, calling analysis, correct follow up, required action taken and updated software, updated productivity report.
• Identifying errors critical to process such as wrong analysis results in incorrect follow up, Incorrect or incomplete information captured on call, Incorrect or incomplete action taken, incomplete production report.
• Ensure the Quality score for the process and Payment Posting callers of the team more than 98% or should meet as per the client expectations.
• Ensure the team must be aware of criticality of Fatal and non-fatal parameters/errors.
• Ensuring the error must be communicated to associate and process owners. Associate provided constructive feedback about the error committed and corrected.
• Ensuring that Corrective Action Policy is adhered to and Improvements seen on individuals being audited.
• Ensure that every week team will be briefed about the major errors committed towards process. Team must be coached about the correct follow ups related to those errors.
• Weekly/Monthly Quality performance report to be mailed to internal client on time. Reports generated must be error free.
• Maintaining the Quality Metrics i.e. Process quality score, Individual quality score, number of errors, Corrective Action policy, Categorization of associates, documentation of Fatal errors, Improvement plans, Process Knowledge Test etc.
• Responsible for random transaction audits and performance of new hires during OJT/Nesting period.

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