Preethi R

QA Analyst

Prochant India Pvt Ltd • Full time

Aug 2019 - Present • 6 yrs 9 mos

 Performed audits on federal healthcare claims (Medicare & Medicaid), ensuring adherence to compliance requirements, proper documentation (CMN, F2F), and accurate coding (ICD-10, CPT, HCPCS).  Handling and mentoring a team of 20 employees for quality and performance improvement.  Conducting daily feedback sessions on previous-day errors and guiding team members on correction methods  Providing training on denial scenarios with real-time examples to enhance problem-solving.  Identifying error trends, analyzing root causes, and recommending corrective actions.  Maintaining audit logs, generating quality scorecards, and presenting weekly/monthly performance insights.  Assisting in SOP revisions and creation of training materials based on audit findings.  Sharing insights with operations team to minimize rework and improve first-pass resolution rates.  Ensuring compliance with client requirements and internal quality benchmarks.  Prepared audit reports with error %, quality %, and financial impact analysis