Quality Analyst

1 week ago


Manila, National Capital Region, Philippines Med-Metrix Full time

On-site - Manila 3-5 Yrs Exp Diploma Full-time

Job DescriptionDescription

Job Purpose

The Quality Analyst- Bilingual supports quality auditing, analysis, reporting and the development of plans that lead to positive outcomes. The Quality Analyst will work on risk identification, diagnosing issues, identifying process improvement solutions and process improvement implementation methods utilizing sound principles. Continuous engagement and collaboration with the Operations and Training Team is essential.

Duties & Responsibilities

  • Ensure that project related quality processes are followed by denials analyst and client specific and internal metrics are achieved.
  • Prepare detailed reports on audit findings and understand the quality requirements both from process perspective and for targets. Deliver reports in a timely manner.
  • Identify a method to achieve the quality targets and implement the same in consultation with QCA lead and/or managers. Assist with the Quality Assessment process to ensure all quality standards targets can be met.
  • Participate in performance improvement activities and continuing education to maintain current credentials and enhance knowledge and skills.
  • Share all relevant information with the team and take initiative to ensure team members get projects completed.
  • Participate in client presentation of findings, when requested.
  • Adjust workloads as necessary to achieve successful completion of project.
  • Handle complaints, questions, and queries as necessary.
  • Disseminates changes in guidelines and rules; monitor changes in laws, regulations, and policies that impact clinical documentation, reimbursement to assure compliance.
  • Foster an environment of teamwork and service excellence within the department.
  • Participate in conference calls/meetings with management and staff to ensure all performance and training recommendations are addressed and improvement suggestions are implemented.
  • Assist in new hire training classes, transition periods and refresher trainings as needed.
  • Maintain knowledge, understanding of, and compliance with all Med-Metrix policies and procedures.
  • Participate in presentations to educate staff on outcomes and plans of correction.
  • Perform other duties as necessary.
  • Use, protect and disclose patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
  • Understand and comply with Information Security and HIPAA policies and procedures at all times.
  • Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties.

Qualifications
  • At least 2 years previous work experience as a Quality Analyst in healthcare insurance collections, self-pay collections and customer service in a call center setting or compliance and/or training.
  • Language Requirement: Spanish and English.
  • Experience with training new users.
  • Knowledge of EOBs, CPT & ICD-9 & 10 codes, HCFAs, UB92s, HCPCS, DRGs and authorizations/ referrals.
  • Strong understanding of the basic healthcare revenue cycle operational processes such as the functions of insurance, patient billing & collections, Managed Care, Medicare, Medicaid, and Commercial Practices.
  • Experience with practice management systems. EPIC PB, Allscripts and/or Cerner preferred.
  • Knowledge of the denied claims and appeals process.
  • Must have an experience in outbound transaction AR process (Payers).
  • Ability to navigate through multiple software and computer applications.
  • Detail oriented and well organized.
  • Capacity to maintain a high level of objectivity when completing staff reviews.
  • Proficient computer skills including Microsoft Office Suite, intermediate Excel skills required.
  • Self-motivated and resourceful with the ability to multitask and successfully operate in a fast paced, team environment.
  • Ability to work well individually and in a team environment.
  • Strong analytical and organizational skills.
  • Strong interpersonal skills, ability to communicate well at all levels of the organization.
  • Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses.
  • High level of integrity and dependability with a strong sense of urgency and results oriented.
  • Ability to meet assigned deadlines and work under minimal supervision and with all levels of staff and management.
  • Excellent written and verbal communication skills required.
  • Gracious and welcoming personality for customer service interaction.

Working Conditions
  • Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
  • Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
  • Work Environment: The noise level in the work environment is usually minimal.

#J-18808-Ljbffr
  • Quality Analyst

    2 weeks ago


    Manila, National Capital Region, Philippines HCL Technologies Philippines Inc Full time

    About the roleHCL Technologies Philippines Inc. is seeking an exceptional Quality Analyst to join our dynamic team. As a Quality Analyst, you will play a crucial role in ensuring the highest standards of quality and customer satisfaction for our IT support services. This full-time position is based in Taguig City, Metro Manila, where you will be part of a...

  • Quality Analyst

    1 week ago


    Manila, National Capital Region, Philippines CEF Solutions Inc. Full time

    On-site - Manila 1-3 Yrs Exp Diploma Full-timeJob DescriptionDescriptionAbout us:CEF Solutions Inc. is a Consulting Services and Business Process Outsourcing (BPO) company specializing in BPO Operations, Operations Management, Process Engineering and Innovation, Cost Optimization, and Staffing solutions. We take pride in our expertise in providing...

  • Quality Analyst

    6 days ago


    Manila, National Capital Region, Philippines VXI Global Holdings B.V. (Philippines) Full time

    Join Our Team as a Quality AnalystAre you passionate about helping others and making a positive impact on people's lives? We are seeking Quality Analysts to support a leading, multi-million-member healthcare organization serving individuals across the United States.As a Quality Analyst, you'll be responsible for monitoring and evaluating transactions for...


  • Manila, National Capital Region, Philippines CBRE GWS IFM PHILS. CORP. Full time

    The Service Quality Analyst is responsible for driving adherence to CBRE quality policy and objectives. This support member ensures superior stakeholder experience by driving FM operations to adhere to the Service Quality Plan.This role involves quality planning, quality assurance, quality control, quality reporting and analytics, and quality improvement....

  • IT Quality Analyst

    5 days ago


    Manila, National Capital Region, Philippines Michael Page International Recruitment Philippines Inc. Full time

    About the roleThis full-time IT Quality Analyst role at one of our clients, a global packaging manufacturing company, listed in the NYSE and part of the Forbes 500 is based in Makati City Metro Manila. You will be responsible for ensuring the quality and reliability of software applications and IT systems, playing a crucial role in the company's overall...


  • Manila, National Capital Region, Philippines New Flavor House, Inc. Full time

    About the roleAs a Quality Assurance Analyst Micro Analyst at New Flavor House, Inc.', you will play a crucial role in ensuring the high quality and safety standards of our food production processes and end products. This full-time position is based in our Potrero Malabon City Metro Manila facility, where you will be responsible for conducting detailed...


  • Manila, National Capital Region, Philippines IntouchCX Full time

    IntouchCX Manila, National Capital Region, PhilippinesJoin or sign in to find your next jobJoin to apply for the Quality Assurance Analyst role at IntouchCX3 days ago Be among the first 25 applicantsAbout IntouchCXIntouchCX is a global leader in customer experience management, digital engagement, and AI and automation solutions. We immerse ourselves in your...


  • Manila, National Capital Region, Philippines Ascendion Full time

    Add expected salary to your profile for insights.Job Responsibilities:Create detailed test cases that match business requirements to ensure data quality.Ability to test in a timely manner that meets SLA.Perform data testing of outputs made by data analysts to ensure quality using SQL.How do your skills match this job?Your application will include the...

  • Quality Analyst

    2 days ago


    Manila, National Capital Region, Philippines Bill Gosling Outsourcing Full time

    Join a Team That's Passionate About Making Lives BetterAt Bill Gosling Outsourcing, we believe that success starts with an amazing team. We are a global leader in outsourcing solutions, focusing on making lives better, one connection at a time. We provide tailored solutions to businesses around the globe, specializing in customer care, sales, and financial...


  • Manila, National Capital Region, Philippines EXL Service Philippines, Inc. Full time

    The ideal candidate for this Quality Compliance Analyst position at EXL Service Philippines, Inc. will have a minimum of 12 months of work experience in a BPO setting, with a focus on banking and financial services. Your extensive knowledge of process guidelines and ability to analyze quality results will enable you to drive continuous improvement...


  • Manila, National Capital Region, Philippines WebFocus Solutions Inc. Full time

    Role Summary:We are looking for a talented Software Quality Analyst to work with our team at WebFocus Solutions Inc. The successful candidate will have a strong background in software quality assurance and be able to analyze complex web architectures.**Key Responsibilities:**Develop and maintain automation test scripts to ensure product quality.Estimate,...


  • Manila, National Capital Region, Philippines Bill Gosling Outsourcing - Philippines Full time

    At Bill Gosling Outsourcing, we believe that success starts with an amazing team. We are a global leader in outsourcing solutions, focusing on making lives better, one connection at a time. We provide tailored solutions to businesses around the globe, specializing in customer care, sales, and financial services. We're looking for enthusiastic, driven...


  • Manila, National Capital Region, Philippines WNS Global Services, Inc. Full time

    Position OverviewThe Healthcare Quality Analyst will play a vital role in ensuring the quality of our healthcare services. Key responsibilities include:Main Responsibilities:Quality Assurance Process Management: Develop and implement quality management programs, ensuring compliance with regulatory requirements.Clinical Review: Conduct thorough reviews of...


  • Manila, National Capital Region, Philippines RingCentral Full time

    Quality Assurance AnalystSay hello to opportunities at Acquire Asia Pacific Philippines Inc. (Acquire BPO) under the RingCentral account (RingCentral).It's not everyday that you consider starting a new career. We're Acquire BPO, and we're happy that someone as talented as you is considering this role.This is where you and your skills come in. We're currently...


  • Manila, National Capital Region, Philippines ING Full time

    Key Responsibilities As a Quality Control Analyst, you will:Conduct thorough visual inspections of sourcing documents.Use artifact specific checklists and techniques to verify the quality of the artifacts.Document and report any discrepancies or issues identified during testing.Support Quality Control team to setup exhaustive checklists for new...


  • Manila, National Capital Region, Philippines Citigroup Full time

    Citigroup is a global financial services company that is committed to providing exceptional service to our clients. We are seeking a highly skilled Data Quality Senior Analyst to join our team in the Philippines.In this role, you will be responsible for ensuring data sourced and provisioned by different areas meets all required data quality standards. The...


  • Manila, National Capital Region, Philippines MED-METRIX INTERNATIONAL PH-I, INC. Full time

    Experience these exceptional benefits when you join Med-Metrix8-Hour Shifts, Fixed Weekends OffDay 1 HMO with 2 of your dependents covered for FREEMedical Cash AllowanceRice AllowanceClothing AllowanceFree Lunch DailyPaid Time OffTraining and Staff DevelopmentEmployee Engagement ActivitiesOpportunities for Internal MobilityThe Quality Analyst, AR Follow Up...

  • Data Quality Analyst

    2 weeks ago


    Manila, National Capital Region, Philippines Tahche Outsourcing Services Inc Full time

    The Data Quality Analyst supports the Online Research Department by analyzing and verifying market research data to ensure accurate, high-quality project deliveries. This role primarily uses SPSS to read, write, and modify SPSS syntax, verifying that data files (.sav) conform to client specifications. The Data Quality Analyst must also communicate any issues...


  • Manila, National Capital Region, Philippines Sagan Recruitment Full time

    Sagan Recruitment seeks a skilled Business Information Analyst to join our team. The successful candidate will play a vital role in ensuring the accuracy and quality of our business information.Responsibilities include reviewing and editing documents generated from ETL templates, identifying and correcting OCR errors, and verifying that all client...

  • Test Analyst

    4 days ago


    Manila, National Capital Region, Philippines QBE GROUP SHARED SERVICES LIMITED - PHILIPPINE BRANCH Full time

    We are looking for a motivated and detail-oriented Test Analyst to join our team at QBE GROUP SHARED SERVICES LIMITED - PHILIPPINE BRANCH.About the Role:This exciting opportunity will see you working closely with data teams and stakeholders to ensure the quality of processes, databases, and system applications.Key Responsibilities:Create and maintain...