AR HB Quality Analyst - Hyderabad

ECLAT Health Solutions; Hyderabad; On-site; INR 400,000 - 600,000; Full time

Job summary

Eclat-Health-Solutions-4 in Hyderabad seeks a Hospital Billing Quality Assurance Analyst to ensure accurate and compliant medical billing processes. The Analyst will audit patient claims, verify medical coding, and resolve discrepancies. The ideal candidate has 2+ years in medical billing, strong knowledge of ICD-10/CPT coding, and proficiency in Billing Software and EHR systems.

Join our team to contribute to improving the revenue cycle performance in a healthcare setting.

Qualifications

• 2+ years of experience in medical billing, coding, or healthcare finance.
• Strong understanding of ICD-10/CPT coding and US healthcare insurance.
• Attention to detail and strong communication skills are essential.

Responsibilities

• Audit medical claims and billing records for accuracy.
• Detect errors in medical coding and patient charges.
• Ensure compliance with HIPAA and insurance policies.
• Recommend improvements to billing workflows.
• Prepare detailed reports on audit findings.
• Reconcile billing discrepancies.

Skills

Experience in medical billing

Knowledge of medical terminology

Proficiency in Billing Software

Attention to detail

Analytical mindset

Strong communication skills

Education

Certification as CPB or CPC

Tools

Billing Software

Electronic Health Records (EHR)

MS Excel

Job description

A Hospital Billing Quality Assurance (QA) Analyst ensures the accuracy, compliance, and efficiency of medical billing processes. They audit patient claims, verify medical coding (ICD/CPT), and resolve billing discrepancies to reduce errors and ensure proper reimbursement. Key duties include reviewing records, checking insurance compliance, and improving revenue cycle performance.

Key Responsibilities

• Audit Claims: Audit medical claims, billing records, and payment data for accuracy and regulatory compliance.
• Identify Errors: Detect errors in medical coding, patient charges, and insurer submissions to prevent denials.
• Compliance: Ensure billing adheres to HIPAA, insurance policies, and organizational standards.
• Process Improvement: Recommend improvements to billing workflows to boost accuracy and efficiency.
• Reporting: Prepare detailed reports on audit findings and performance metrics.
• Reconciliation: Reconcile billing discrepancies and support AR (Accounts Receivable) teams.

Required Skills and Qualifications

• Experience: 2+ years of experience in medical billing, coding, or healthcare finance.
• Knowledge: Strong understanding of medical terminology, ICD-10/CPT coding, and US healthcare insurance (if applicable).
• Tools: Proficiency in Billing Software, Electronic Health Records (EHR) systems, and MS Excel.
• Certification: Certified Professional Biller (CPB), Certified Professional Coder (CPC), or equivalent preferred.
• Soft Skills: Attention to detail, analytical mindset, and strong communication skills.

Job Scope

These roles are common within hospitals, billing companies, and healthcare providers, often involving US healthcare RCM (Revenue Cycle Management) or domestic billing audits.