Quality Analyst

GetixHealth; Bengaluru; On-site; INR 450,000 - 700,000; Full time

Job summary

GetixHealth, LLC is seeking a Quality Analyst to ensure accuracy, compliance, and efficiency across medical billing processes. The role conducts audits, analyzes claims and documentation, and collaborates with teams to uphold high billing standards.

The ideal candidate has strong attention to detail, excellent communication, and the ability to adapt to evolving regulatory requirements. Based in Eco Space, Bellandur (Bangalore), the position requires work from office with night transport from

Qualifications

• Experience in quality audits of medical billing processes.
• Ability to review claims and documentation for accuracy.
• Knowledge of coding guidelines and regulatory requirements.
• Strong communication and collaborative skills.

Responsibilities

• Conduct quality audits on medical billing processes, claims and documentation for accuracy and compliance.
• Review medical records, claims, and billing data to identify errors and improvement opportunities.
• Stay updated on billing regulations and coding guidelines to ensure ongoing compliance.
• Monitor quality metrics and prepare management reports with trends and corrective actions.
• Collaborate with team to provide feedback, training, and guidance on accuracy and compliance.

Skills

Quality audits

Medical billing

Regulatory compliance

Documentation review

Analytical skills

Attention to detail

Communication skills

Team collaboration

Time management

Education

Any Graduation

Job description

Job Summary

The Quality Analyst is responsible for ensuring accuracy, compliance, and efficiency across medical billing processes. This role involves conducting audits, analyzing claims and documentation, identifying improvement opportunities, and collaborating with the team to maintain high standards of billing performance. The ideal candidate maintains strong attention to detail, excellent communication skills, and the flexibility to adapt to evolving business needs.

Key Responsibilities

• Conduct quality audits on medical billing processes, claims, and documentation to ensure accuracy, compliance, and adherence to industry standards and regulatory requirements.
• Review and analyze medical records, claims, pre-billing activities, coding, and billing data to identify errors, discrepancies, and areas for improvement.
• Stay updated on changes in medical billing regulations, coding guidelines, and industry best practices to ensure ongoing compliance.

Process Improvement & RCA

• Perform Root Cause Analysis for recurring issues and implement corrective and preventive actions.
• Participate in meetings, discussions, and cross-functional initiatives to identify process improvement opportunities.
• Assist in resolving complex billing issues, denials, and appeals.

Quality Control & Reporting

• Develop and maintain quality control procedures, guidelines, and checklists for consistent and accurate billing practices.
• Monitor and track key quality metrics and prepare reports for management, highlighting trends, concerns, and recommended corrective actions.
• Maintain Turnaround Time standards while upholding accuracy and quality expectations.

Team Collaboration & Training

• Collaborate with team members to provide feedback, training, and guidance related to accuracy, documentation quality, and regulatory compliance.
• Offer support to team and leadership as needed and adapt to evolving business requirements.

Professional Attributes

• Demonstrate strong communication skills and the ability to interact effectively with internal teams and stakeholders.
• Exhibit flexibility to work from the office as required to support operational and organizational priorities.
• Show the ability to take on varied responsibilities and contribute proactively to team success.

Required Skills & Competencies

• Strong understanding of medical billing, coding, and compliance guidelines
• Excellent analytical and auditing skills
• Attention to detail and accuracy in reviewing documentation
• Proficiency in identifying process gaps and implementing corrective actions
• Strong verbal and written communication skills
• Ability to manage deadlines and maintain TAT
• Ability to work independently and collaboratively

Education

Any Graduation in any discipline from a reputed college

Location

Eco Space, Bellandur (Bangalore)

Designation

Quality Analyst

Transport

6:30 PM to 3:30 AM (Office Transport will Be provided)

Experience

1+ years

Note

Work from office