Quality Analyst
2 hours ago
Job Summary:
We are seeking a meticulous and experienced Quality Analyst to monitor and enhance the accuracy and compliance of medical billing operations in a US healthcare call center environment. The ideal candidate will have a strong understanding of RCM workflows, call center quality metrics, and US healthcare billing standards.
Key Responsibilities:
- Audit voice and non-voice transactions across RCM functions including charge entry, payment posting, AR follow-up, and patient/provider interactions.
- Evaluate call recordings and documentation for accuracy, completeness, and adherence to client-specific and regulatory guidelines.
- Identify quality gaps and provide constructive feedback to agents and team leaders.
- Collaborate with training and operations teams to address recurring errors and improve overall quality.
- Maintain detailed audit logs and generate periodic quality reports for internal and client review.
- Participate in calibration sessions to ensure consistency in quality standards.
- Support internal and external audits and ensure HIPAA compliance.
- Recommend process improvements based on audit findings and trend analysis.
Required Skills & Qualifications:
- High school graduate and above; certification in medical billing or healthcare compliance is a plus.
- 3–5 years of experience in US medical billing, with at least 1–2 years in a quality/auditing role.
- Strong knowledge of CPT, ICD-10, HCPCS codes, and payer-specific billing rules.
- Experience in a call center environment with exposure to call quality metrics.
Job Types: Full-time, Permanent
Pay: Up to Php35,000.00 per month
Benefits:
- Additional leave
- Company Christmas gift
- Company events
- Health insurance
- Opportunities for promotion
- Pay raise
- Promotion to permanent employee
Work Location: In person
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