Healthcare Provider Services Quality Auditor

Imagenet Phils., Inc.; Makati; On-site; PHP 400,000 - 700,000; Full time

Benefits offered by this job

HMO Coverage

Day-1 HMO for dependents

Job summary

Imagenet Phils., Inc. is seeking a Healthcare Quality Auditor for Provider Services in Metro Manila. You will review provider interactions, claims-related work, and documentation to ensure accuracy, compliance, and high provider experience.

You will apply QA scorecards, audit forms, and SOPs, identify gaps, and provide clear feedback to Advocates and operations partners. The role requires 4–5 years in healthcare QA and the ability to work flexible hours.

Qualifications

• At least 4–5 years in healthcare contact center, provider services, or QA role.
• 2–3 years as Quality Auditor/QA-Analyst/SME.
• Strong knowledge of claims, EOBs, eligibility, benefits, and payments.
• Ability to interpret QA guidelines and justify audit findings.
• Excellent written and verbal communication.
• Ability to work nights, weekends, holidays as needed.
• Proficiency with multiple systems and software.

Responsibilities

• Perform QA audits of provider-service interactions and documentation.
• Meet audit volume, sampling, and turnaround targets.
• Review data accuracy, policy accuracy, and compliance.
• Provide actionable audit feedback to staff and leaders.
• Maintain audit records in QA platforms.
• Identify recurring errors and escalation needs.

Skills

Analytical thinking

Problem-solving

Decision-making

Organizational skills

Verbal communication

Written communication

Attention to detail

Customer service excellence

Flexibility with schedules

Education

High school diploma or equivalent

College degree preferred

Healthcare or QA-related coursework

Tools

Microsoft Office

Monday.com

AWS Connect

QA platforms

Call recording tools

Claims systems

Workforce management tools

Performance dashboards

Job description

Imagenet Phils., Inc. is seeking a Healthcare Quality Auditor for Provider Services in Metro Manila. You will review provider interactions, claims-related work, and documentation to ensure accuracy, compliance, and high provider experience.

You will apply QA scorecards, audit forms, and SOPs, identify gaps, and provide clear feedback to Advocates and operations partners. The role requires 4–5 years in healthcare QA and the ability to work flexible hours.