Healthcare Process & Quality Auditor for SLA & TAT

eData Services US, L.L.C.; Taguig; Vor Ort; PHP 420.000 - 680.000; Vollzeit

Zusammenfassung

eData Services US, L.L.C. is seeking an Internal Process, Quality, and TAT Auditor to join our Operational Excellence team in the Philippines.

You will safeguard healthcare accounts by ensuring SLA compliance, HIPAA privacy, and high-quality work, while digging into root causes to remove bottlenecks and optimize workflows. You will partner with floor leadership to drive improvements across Utilization Review, RCM, and scheduling, using data to push continuous performance gains in a fast-paced

Qualifikationen

• 3–5 years of experience in Healthcare BPO/KPO, with 1–2 years in QA/audit.
• Specialized domain knowledge in workers' compensation and med-legal services.
• Strong understanding of US healthcare frameworks, payer/provider dynamics, and HIPAA data privacy.

Aufgaben

• Audit and validate daily healthcare workflows (Utilization Review, RCM, scheduling).
• Monitor end-to-end lifecycle times and aging reports to prevent SLA breaches.
• Lead Root Cause Analysis and collaborate with Operations Supervisors to implement CAPA plans.
• Proactively recommend workflow changes, resource realignment, or automation opportunities.
• Conduct calibration sessions with Production Leadership to ensure alignment on quality standards.
• Build and maintain daily/weekly dashboards detailing error trends, SLA performance, and compliance metrics.

Kenntnisse

Quality Assurance

Root Cause Analysis

Data analysis

SLA compliance

Process improvement

Auditing

Ausbildung

Bachelor's Degree

Healthcare Admin or Finance (preferred)

Tools

Excel/Google Sheets

IMS

Epic

Salesforce

Jobbeschreibung

eData Services US, L.L.C. is seeking an Internal Process, Quality, and TAT Auditor to join our Operational Excellence team in the Philippines.

You will safeguard healthcare accounts by ensuring SLA compliance, HIPAA privacy, and high-quality work, while digging into root causes to remove bottlenecks and optimize workflows. You will partner with floor leadership to drive improvements across Utilization Review, RCM, and scheduling, using data to push continuous performance gains in a fast-paced