Quality Assurance Specialist

Minimum Qualifications:

• Bachelor's degree preferred or equivalent work experience.
• Consultancy basis minimum of 6 months consultancy contract (subject for renewal)
• Minimum 1–3 years experience in Healthcare Billing, Medical Billing,
• Dental Billing, AR, or Revenue Cycle Management.
• QA or audit experience in a BPO/shared services environment preferred.
• Strong knowledge of claims lifecycle, denials management, AR follow-up, payment posting, and productivity metrics.
• Advanced Excel / Google Sheets reporting skills preferred.
• Strong analytical, documentation, and stakeholder management skills.

Salary: PHP 30,000 - 40,000 / month

Job Description:

• Conduct routine and random audits of healthcare billing transactions including charges, payments, claims follow-up, denials, and AR activities.
• Review daily, weekly, and monthly productivity reports of billing associates.
• Validate logged production against actual completed work.
• Investigate quota discrepancies, overstatements, duplicate entries, or unsupported outputs.
• Monitor AR aging inventory and collector activity.
• Audit follow-up actions for unpaid, denied, underpaid, or pending claims.
• Ensure adherence to client SOPs, HIPAA standards, internal controls, and company policies.
• Monitor completion of required trackers, checklists, and month-end deliverables.
• Support implementation of new controls, metrics, and process enhancements.
• Prepare QA scorecards, performance dashboards, and error trend analysis.
• Present findings to Team Leads, Supervisors, and Management.
• Provide structured feedback to employees and leaders based on audit results.