CQM Coordinator

Full time at Accumed Practice Management DMCC in UAE

Posted on January 24, 2025

Job details

Job Family Summary: Revenue Operations is characterized by consistency of actions, values, methods, measures, principles, expectations and outcomes. It comprises of capacity management, production planning, timely reporting and timely submission to the insurance companies with coordination with the revenue integrity. Role Summary: The CQM Coordinator role is responsible for engaging team members in the claims process, identifying network issues, and communicating with IT to resolve those. Coordination with team members to achieve the organization’s goals is essential. Primary Responsibilities:

Allocation of claims to the team members, ensuring that each team member receives claims.
Report back to line managers/onsite managers on any claims process issues that may affect the process.
Meet with the team regularly to discuss challenges in the claims process.
Escalate IT on network issues, track those, and keep in a shared folder to share with management.
Monitor the CQM process within the given TAT with the provider as well as with the end user.
Gather relevant information to clearly describe and properly escalate issues to supervisors and managers.
Ensure high-quality customer service and respect medical and work ethics at all times while conducting daily tasks.
Document business decisions and processes professionally and adhere to communication requirements in a timely manner.
Provide all needed support as advised by the supervisor based on business needs.
Perform other related tasks assigned by the line manager.

Desired Candidate Profile:

Bachelor’s Degree or PG in Medical, paramedical, or any life science.
Most relevant coding certification with updated membership to a body as accepted by the geographical governance area (CPC, COC, CIC, CPMA, CCS, etc.).
Relevant experience of at least 2 years in claims processing.
Good IT skills.
Knowledge of ICD’s, CPT’s & coding guidelines.

Employment Type: Full Time Company Industry:

Medical
Medical Devices

Department / Functional Area:

Insurance
Surveying
Actuary

Keywords:

Revenue Operations
Claims Processing
Query Management
CPC
COC
CIC
CCS
Team Coordination
TAT Management
Revenue Cycle Management
Medical Coding
Health Insurance Claims

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CQM Coordinator

Job details

Apply safely

Hiring company

Accumed Practice Management DMCC

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