Analyze pre-certification, Medical Decision Reviews and research and identify billing practices and issues
Review and negotiate appeals to evaluate compliance with applicable statutory and regulatory requirements, industry best practices
Participates in project meetings, providing QC shop inspection updates as required, communicating relevant information to other quality professionals and inspectors as appropriate, updates ITPs
Interfaces for development of respective shop inspection documentation packages, identification of unique inspection requirements and any other aspects to highlight or communicate to the assigned shop inspector in support of shop inspection activities
Reviews inspection reports for content quality, completion, clarity and consistency
May be required to mentor staff
Generates records, reports, correspondence, distributes appropriately and identifies improvement opportunities
Effectively and efficiently plan quality control activities to support the overall manufacturing process
Provide technical guidance to the QC team and assists with planning for special projects and quality control exceptions as needed
Assist QC supervisors with tactical decisions in quality control to support planning requirements and execution by QC staff