QA Analyst

AP Management Consultants; Puducherry; On-site; INR 250,000 - 420,000; Full time

Job summary

AP Management Consultants in Puducherry, India seeks a Payment Posting QA Auditor to ensure accuracy of audit payment postings and reconcile with source documents.

You will compare system postings with EOBs, ERAs, and remittances, verify patient and claim details, and identify underpayments or denials. This role requires adherence to SOPs and data privacy.

The team focuses on quality, productivity, and timely turnaround, providing coaching to associates and maintaining QA records.

Responsibilities

• Audit Payment Posting transactions for accuracy.
• Compare system postings with EOBs, ERAs, and payment remittances.
• Verify correct patient, claim, payer, payment amount, and service line.
• Check payments, adjustments, write-offs, denials, refunds, and patient responsibility.
• Identify and document incorrect, duplicate, or missing transactions.
• Validate CARC/RARC and denial codes where applicable.
• Identify underpayments, overpayments, zero-pay, and unapplied cash.
• Classify errors as critical/non-critical and financial/non-financial.
• Provide feedback and coaching to Payment Posting associates.
• Track recurring errors and support Root Cause Analysis (RCA).
• Maintain QA reports, error logs, and audit records.
• Meet defined quality, productivity, and turnaround-time targets.
• Follow SOPs, HIPAA, and data privacy/security guidelines

Job description

Roles & Responsibilities:

• Audit Payment Posting transactions for accuracy.
• Compare system postings with EOBs, ERAs, and payment remittances.
• Verify correct patient, claim, payer, payment amount, and service line.
• Check payments, adjustments, write-offs, denials, refunds, and patient responsibility.
• Identify and document incorrect, duplicate, or missing transactions.
• Validate CARC/RARC and denial codes where applicable.
• Identify underpayments, overpayments, zero-pay, and unapplied cash.
• Classify errors as critical/non-critical and financial/non-financial.
• Provide feedback and coaching to Payment Posting associates.
• Track recurring errors and support Root Cause Analysis (RCA).
• Maintain QA reports, error logs, and audit records.
• Meet defined quality, productivity, and turnaround-time targets.
• Follow SOPs, HIPAA, and data privacy/security guidelines.