Healthcare QA Analyst: Revenue & Compliance

Med-Metrix; Pasig; On-site; PHP 360,000 - 540,000; Full time

Benefits offered by this job

Day 1 HMO coverage for employee and 2-

Clothing Allowance

Free Lunch Daily

Paid Time Off

Training and Staff Development

Employee Engagement Activities

Internal Mobility Opportunities

Job summary

Med-Metrix in Metro Manila seeks a Quality Analyst to support auditing, analysis, reporting, and improvement plans for positive outcomes. The role collaborates with Operations and Training to address quality standards and HIPAA compliance.

Night shift, onsite in Pasig, with duties including detailed audit reporting, training support, and performance improvement initiatives to ensure top-tier service delivery.

Qualifications

• At least 2 years previous work experience as a Quality Analyst in healthcare insurance collections, self-pay collections and customer service in a call center setting or compliance and/or training.
• Experience with training new users.
• Knowledge of EOBs, CPT & ICD-9 & 10 codes, HCFAs, UB92s, HCPCS, DRGs and authorizations/referrals.
• Strong understanding of revenue cycle processes in insurance, patient billing & collections.
• Experience with practice management systems (EPIC PB, Allscripts and/or Cerner preferred).
• Knowledge of denied claims and appeals process.
• Ability to navigate multiple software applications and multitask in a fast-paced environment.
• Strong interpersonal and communication skills; proactive and team-oriented.

Responsibilities

• Ensure project quality processes are followed and metrics are achieved.
• Prepare detailed audit reports and understand quality requirements from process and target perspectives.
• Identify methods to achieve quality targets and implement with QCA lead or managers.
• Participate in performance improvement activities and ongoing education.
• Share information with the team and ensure project completion.
• Participate in client presentations of findings when requested.
• Adjust workloads to meet project deadlines and handle inquiries.
• Maintain HIPAA compliance and protect PHI; monitor policy changes.

Skills

Quality Analyst

Healthcare knowledge

Training experience

HIPAA compliance

Analytical skills

Communication

Tools

EPIC PB

Allscripts

Cerner

Job description

Med-Metrix in Metro Manila seeks a Quality Analyst to support auditing, analysis, reporting, and improvement plans for positive outcomes. The role collaborates with Operations and Training to address quality standards and HIPAA compliance.

Night shift, onsite in Pasig, with duties including detailed audit reporting, training support, and performance improvement initiatives to ensure top-tier service delivery.