Quality Assurance Consultant

This is a fully remote position, open to applicants in Philippines.

📋 Description

• Perform routine and ad-hoc audits of healthcare billing transactions, covering charges, payments, claims follow-up, denials, and accounts receivable activities.

• Analyze daily, weekly, and monthly productivity reports for billing associates.

• Confirm logged production aligns with actual completed tasks.

• Examine discrepancies in quotas, overstatements, duplicate entries, or unsupported outputs.

• Supervise accounts receivable aging inventory and collector activities.

• Audit follow-up measures for unpaid, denied, underpaid, or pending claims.

• Ensure compliance with client Standard Operating Procedures (SOPs), HIPAA regulations, internal controls, and company policies.

• Oversee the completion of essential trackers, checklists, and month-end deliverables.

• Assist in the implementation of new controls, metrics, and process improvements.

• Generate Quality Assurance scorecards, performance dashboards, and error trend analyses.

• Present findings to Team Leads, Supervisors, and Management.

• Offer structured feedback to employees and leaders based on audit outcomes.

⛳️ Requirements

• Bachelor's degree preferred or equivalent professional experience.

• Minimum consultancy contract of 6 months required (renewable based on performance).

• At least 1–3 years of experience in Healthcare Billing, Medical Billing, Dental Billing, Accounts Receivable, or Revenue Cycle Management.

• Preferred experience in QA or auditing within a BPO/shared services environment.

• Strong understanding of the claims lifecycle, denials management, accounts receivable follow-up, payment posting, and productivity metrics.

• Advanced reporting skills in Excel or Google Sheets are preferred.

• Excellent analytical, documentation, and stakeholder management skills.

🏝️ Benefits

• Company-provided equipment and computer.

• Opportunity to work from home.