Quality Assurance Representative

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

📋 Description

• The Quality Analyst position involves the examination of account activities, documentation, billing actions, denials, adjustments, and follow-up processes to guarantee accuracy, compliance, and alignment with client and departmental standards.

• This role enhances quality improvement by recognizing trends, documenting findings, and communicating issues that could affect account resolution or workflow performance.

• Review account documentation to ensure that notes are comprehensive, precise, and entered into the appropriate client system.

• Conduct audits on billing, rebilling, denial follow-up, appeal activities, adjustments, and account resolution actions for accuracy and compliance.

• Monitor denials, correspondence, and account trends to identify recurring issues or gaps in processes.

• Confirm that demographic, insurance, address, and plan updates are accurately completed to maintain account integrity.

• Ensure that work adheres to relevant client requirements, standard operating procedures, HIPAA guidelines, and state or federal regulations.

• Clearly document QA findings and communicate trends, errors, or concerns to leadership for review and further action.

• Assist with special projects, training initiatives, and process improvement efforts focused on quality, accuracy, and workflow performance.

⛳️ Requirements

• High School Diploma / GED or 3 years of Relevant Equivalent Experience in Place of Diploma / GED

• 0-2+ years of experience in office, business, operations, customer service, or the healthcare field

• Previous experience with insurance portals is a plus

• Proficiency in a Windows environment is preferred

• Familiarity with desktop applications, including Word and Excel, is advantageous

• Capability to initiate and complete projects and work independently with minimal supervision is beneficial

🏝️ Benefits

• Medical, Rx, Dental & Vision Insurance

• Personal and Family Sick Time & Company Paid Holidays

• Position may qualify for a discretionary variable incentive bonus

• Parental Leave

• 401(k) Retirement Plan

• Basic Life & Supplemental Life Insurance

• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts

• Short-Term & Long-Term Disability Insurance

• Tuition Reimbursement, Personal Development & Learning Opportunities

• Skills Development & Certifications

• Employee Referral Program

• Corporate Sponsored Events & Community Outreach

• Emergency Back-Up Childcare Program