Quality Assurance Specialist

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

📋 Description

• Perform both routine and random audits on healthcare billing transactions, which include charges, payments, claims follow-up, denials, and accounts receivable activities.

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

• Confirm that logged production aligns with actual work completed.

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

• Oversee accounts receivable aging inventory and the performance of collectors.

• Review follow-up actions regarding unpaid, denied, underpaid, or pending claims.

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

• Track the completion of necessary trackers, checklists, and month-end deliverables.

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

• Develop quality assurance scorecards, performance dashboards, and error trend analyses.

• Share findings with Team Leads, Supervisors, and Management.

• Deliver structured feedback to employees and leadership based on audit outcomes.

⛳️ Requirements

• A bachelor's degree is preferred, or equivalent professional experience.

• Minimum of 6 months consultancy contract required (renewal subject to evaluation).

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

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

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

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

• Strong analytical, documentation, and stakeholder management abilities.

🏝️ Benefits

• A company-provided computer or equipment.

• Opportunity to work from home.