Quality Analyst
2 days ago
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.
Requirement:
- 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.
- Able to work on Holidays is preferable.
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