AR Quality Analyst

Overview

Lennor Metier Consulting, a DOLE-licensed headhunting and recruitment agency in the Philippines, is proud to partner with a Healthcare RCM company in their search for an AR Quality Analyst based in Pasig .

Salary Range: up to ₱55,000

Work Setup: Onsite

Shift Schedule: Night Shift (9PM-5AM)

Location: Pasig City

We are seeking a detail-oriented and proactive AR Quality Analyst to join our team. This role plays a vital part in monitoring and improving quality standards across operations. The Quality Analyst will be responsible for auditing processes, identifying risks, analyzing performance gaps, and developing actionable improvement plans. Collaboration with Operations, Training, and Management teams is key to ensuring compliance with client expectations, internal targets, and industry regulations.

Responsibilities

• Conduct regular quality audits to ensure processes are followed and client-specific as well as internal performance metrics are consistently met.
• Prepare clear and timely reports on audit findings, including actionable recommendations for performance and process improvements.
• Partner with the Quality Lead and/or Managers to identify methods to achieve quality targets and implement corrective actions.
• Participate in performance improvement initiatives, including training sessions, refresher courses, and continuing education activities.
• Share relevant updates, guidelines, and industry changes with team members to support compliance and service excellence.
• Provide input and, when needed, participate in client presentations to share quality findings and recommendations.
• Adjust and prioritize workloads to meet project timelines and ensure successful outcomes.
• Address complaints, questions, and queries, escalating when necessary.
• Monitor changes in laws, policies, and regulations impacting clinical documentation and reimbursement to ensure compliance.
• Support training efforts for new hires, transition periods, and ongoing refresher sessions.
• Foster teamwork and a culture of accountability, excellence, and collaboration within the department.
• Participate in meetings and conference calls with management and staff to discuss performance outcomes, training needs, and improvement opportunities.
• Handle patient information with the utmost confidentiality and ensure strict compliance with HIPAA and information security standards.

• Minimum of 2 years’ experience as a Quality Analyst in healthcare insurance collections, self-pay collections, call center customer service, compliance, and/or training.
• Hands-on experience with outbound transaction AR processes (Payers).
• Solid knowledge of:
• • Explanation of Benefits (EOBs), CPT, ICD-9/10 codes, HCPCS, DRGs, and authorizations/referrals.
  • Healthcare billing forms such as HCFAs and UB92s.
  • Denied claims and appeals process.
  • Revenue cycle operations including insurance, patient billing & collections, Managed Care, Medicare, Medicaid, and commercial practices.
  • Experience with practice management systems; EPIC PB, Allscripts, and Cerner preferred.

• Strong computer proficiency, including Microsoft Office Suite and intermediate Excel skills.
• Excellent analytical, organizational, and problem-solving skills with the ability to make sound judgments.
• High level of objectivity when evaluating staff performance.
• Strong interpersonal and communication skills (written and verbal), with the ability to interact across all levels of the organization.
• Customer-focused attitude with a professional and approachable demeanor.
• Ability to multitask, work independently, meet deadlines, and thrive in a fast-paced, team-oriented environment. High integrity, dependability, and a strong sense of urgency and results orientation.

• HMO on Day 1 with FREE dependents
• Paid Time Off
• Internal Growth Opportunity

Ready to take the next step in your career? Submit your application now