Quality Analyst

3 weeks ago

Muntinlupa, Philippines Gear Inc Full time

Quality Assurance & Performance Monitoring

  • Audit a daily sample of billers' case transcripts.
  • Document audit results in a standardized tracker and ensure completeness and consistency of findings.
  • Identify patterns and recurring errors from audit results and escalate major discrepancies or compliance risks to Team Leads or Ops Managers.
  • Collaborate with TLs and Trainers to align on recurring issues and plan targeted coaching or refresher training sessions.
  • Support calibration sessions to maintain scoring alignment with client and operational leads.
  • Provide clear and structured feedback to specialists based on audit results.
  • Handle QA-related inquiries, audit appeals, validate audit logic, and update feedback if necessary.
Reporting & Insights
  • Generate and analyze daily, weekly, or ad hoc QA reports to provide insights on team quality trends and process bottlenecks.
  • Flag outliers, productivity-to-quality gaps, and compliance risks in collaboration with Operations and Training.
  • Prepare QA summaries for client-facing decks and internal reviews as needed.
Cross-Functional Collaboration
  • Partner with Trainers and Operations to conduct joint root cause analysis and process refinement.
  • Participate in internal syncs, updates, or policy briefings to stay aligned with client expectations.
  • Support internal and external calibration sessions and provide QA representation in client or compliance reviews.
Requirements
  • Fluent in English (C1 level or above), with strong communication and leadership skills.
  • Excellent verbal and written communication skills in English, with the ability to express ideas clearly and concisely.
  • Be detail-oriented with strong analytical skills;
  • Proficient skills with MS Office and Google Drive;
  • Minimum of 1 year experience in healthcare AR, revenue cycle, or medical billing, with at least 1 year in a leadership role (external candidate).
  • In-depth knowledge of billing practices, payer guidelines, denial management, and compliance standards (e.g., HIPAA).
  • Strong analytical, decision-making, and problem-solving skills.
  • Comfortable using billing systems, claim portals, and productivity monitoring tools.
  • Ability to thrive in a fast-paced, client-driven environment.
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