RCM - Quality Analyst (Medical Billing)

2 weeks ago

Taguig, National Capital Region, Philippines ALLDIGI TECH MANILA, INC. (AMI) Full time ₱600,000 - ₱800,000 per year

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.

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