Provider Data Quality Analyst - Hybrid

Blue Cross and Blue Shield of Kansas; Topeka (KS); Hybrid; USD 55,000 - 78,000; Full time

Benefits offered by this job

Health insurance

Vision/Dental insurance

6 weeks paid parental leave

Fertility/Adoption assistance

2 weeks paid caregiver leave

401(k) match up to 5%

Tuition reimbursement

Health & fitness benefits

Job summary

Blue Cross and Blue Shield of Kansas is seeking a Quality Analyst to ensure provider records are created and maintained accurately, meeting BCBS Association and federal requirements. The role includes data audits and logging errors to guide system improvements, with onsite training for at least 90 days and then hybrid or onsite work per Telecommuting Policy.

Applicants must reside in Kansas or Missouri or be willing to relocate.

Qualifications

• Ability to write procedural documents as training manuals.
• Ability to review audit language and regulatory requirements to form actionable procedures for data review.
• Excellent verbal and written communication and human relation skills with the ability to interact positively with all levels of internal and external customers.
• Ability to perform detailed research and gather supporting documentation to understand and interpret procedural work assignments.
• Proven ability to work as a member of a team and assist in meeting departmental goals and objectives.
• Work requires good organizational skills and ability to work independently, with a high level of integrity and accuracy.

Responsibilities

• Research and make recommendations for quality improvement to ensure data accuracy standards.
• Provide feedback to production supervisors and managers regarding data accuracy.
• Serve as the primary contact for provider data accuracy inquiries from the Association, Federal regulators, and internal audit teams.
• Identify and review statistically valid data samples for each Provider Network team member.
• Track error categories and report on corrective actions and data outreach.
• Review and identify prioritization of Association and regulatory data errors.
• Complete data updates in provider network system applications.
• Coordinate data accuracy resolution with institutional relations, professional relations, and provider records.
• Respond to the Association, legal, compliance and CMS upon inquiry and resolution within time frames.
• Establish and maintain annual project plans to ensure provider data accuracy.

Skills

Procedural writing

Communication

Audit/regulatory review

Data integrity

Team collaboration

Job description

Blue Cross and Blue Shield of Kansas is seeking a Quality Analyst to ensure provider records are created and maintained accurately, meeting BCBS Association and federal requirements. The role includes data audits and logging errors to guide system improvements, with onsite training for at least 90 days and then hybrid or onsite work per Telecommuting Policy.

Applicants must reside in Kansas or Missouri or be willing to relocate.