Healthcare Quality Analyst — Audit & Process Improvement

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

Job summary

Med-Metrix in Philippines is seeking a Quality Analyst to support quality auditing, analysis, reporting and improvement plans in healthcare collections. The role emphasizes risk identification, issue diagnosis, and implementing process improvements with collaboration from Operations and Training teams.

You will prepare audit reports, ensure denials processes meet targets, and participate in ongoing education to maintain credentials.

Qualifications

• Minimum 2 years as a Quality Analyst in healthcare insurance, collections or call center compliance/training.
• Experience training new users and understanding EOBs, CPT/ICD codes, HCFA forms and referrals.
• Knowledge of revenue cycle processes across insurance, billing, managed care, and medicare/medicaid.

Responsibilities

• Ensure QA processes are followed and metrics are achieved.
• Prepare detailed audit reports and explain quality requirements for targets.
• Identify improvements and implement with QCA lead and managers.
• Participate in performance improvement activities and training.
• Share information with the team and manage project workload.
• Engage in client presentations of findings when requested.
• Maintain HIPAA compliance and monitor policy changes.

Skills

Interpersonal skills

Communication skills

Problem solving

Multitasking

Attention to detail

HIPAA compliance

Time management

Team collaboration

Tools

EPIC PB

Allscripts

Cerner

Microsoft Office Suite

Job description

Med-Metrix in Philippines is seeking a Quality Analyst to support quality auditing, analysis, reporting and improvement plans in healthcare collections. The role emphasizes risk identification, issue diagnosis, and implementing process improvements with collaboration from Operations and Training teams.

You will prepare audit reports, ensure denials processes meet targets, and participate in ongoing education to maintain credentials.