PB-QA Hyd (19-Dec-25)

Eclat-Health-Solutions-4; Hyderabad; On-site; INR 40,000 - 60,000; Full time

Job summary

Eclat-Health-Solutions-4 is seeking a QA – Physician Billing role in Hyderabad, India. The position focuses on ensuring accuracy and compliance in accounts receivable processes related to physician billing. Responsibilities include auditing AR work, identifying trends in denials and underpayments, and collaborating with teams to enhance quality standards. Key skills required include knowledge of payer policies and coding guidelines, along with strong communication abilities. Join us to contribute to process improvements and maximize reimbursements.

Qualifications

• Experience in auditing AR work related to physician billing.
• Strong understanding of payer guidelines and coding standards.
• Ability to identify trends in denials and underpayments.

Responsibilities

• Perform quality audits on Physician Billing AR work.
• Review EOBs, ERAs, and payer correspondence for accuracy.
• Validate correct application of payer rules and coding guidelines.
• Identify root causes of denials and underpayments.
• Track and report QA scores and error trends.

Skills

Quality audits

Medical coding guidelines

Payer policies

Communication

Process improvement

Job description

The QA – Physician Billing is responsible for ensuring accuracy, compliance, and quality of AR processes related to physician billing. The role focuses on auditing AR work, identifying trends in denials and underpayments, ensuring adherence to payer guidelines, and driving process improvements to maximize reimbursements.

Key Responsibilities

Perform quality audits on Physician Billing AR work including follow-ups, appeals, and payment postings

Review EOBs, ERAs, and payer correspondence for accuracy and compliance

Validate correct application of payer rules, contract terms, and coding guidelines

Identify root causes of denials, underpayments, and write-offs

Track and report QA scores, error trends, and performance metrics

Provide feedback, coaching, and corrective action plans to AR teams

Ensure compliance with HIPAA, payer policies, and internal SOPs

Support process improvement initiatives and best practices

Assist in training new AR staff on quality standards

Collaborate with Team Leads, Managers, and Coding teams to resolve issues