Healthcare Quality Analyst: Process & Compliance

Med-Metrix; Pasig; On-site; PHP 300,000 - 540,000; Full time

Benefits offered by this job

Fixed weekends off

Day 1 HMO

Medical cash allowance

Rice allowance

Clothing allowance

Free lunch daily

Paid time off

Training and staff development

Employee engagement activities

Internal mobility

Job summary

Med-Metrix is seeking a Quality Analyst to support quality auditing, analysis, reporting, and improvement initiatives within healthcare insurance collections and compliance. The role emphasizes risk identification, process improvement, and collaboration with Operations and Training teams.

You will work on denials, audits, and performance metrics while ensuring HIPAA and information security standards are upheld. A customer-focused, detail-oriented professional will thrive here.

Qualifications

• At least 2 years as a Quality Analyst in healthcare insurance collections, self-pay collections or call center compliance/training.
• Experience training new users.
• Knowledge of EOBs, CPT & ICD-9/10, HCPCS, DRGs and authorizations/referrals.
• Understanding of healthcare revenue cycle processes (insurance, billing, collections, managed care).
• Experience with practice management systems (EPIC PB, Allscripts and/or Cerner preferred).
• Knowledge of denied claims and appeals process.
• Experience with outbound transaction AR processes (payers).
• Able to navigate multiple software applications.
• Detail oriented and organized.
• Strong analytical and interpersonal skills.

Responsibilities

• Ensure project quality processes are followed; meet internal metrics.
• Prepare detailed audit reports on findings and targets.
• Identify methods to achieve quality targets with QCA lead/management.
• Participate in performance improvement activities and ongoing education.
• Share information with the team to ensure project completion.
• Assist in client presentations of findings when requested.
• Adjust workloads to meet project deadlines.
• Handle inquiries and questions from stakeholders.
• Monitor changes in HIPAA policies and reimbursement guidelines.

Skills

Analytical skills

Communication skills

HIPAA compliance

Attention to detail

Time management

Tools

EPIC PB

Allscripts

Cerner

Job description

Med-Metrix is seeking a Quality Analyst to support quality auditing, analysis, reporting, and improvement initiatives within healthcare insurance collections and compliance. The role emphasizes risk identification, process improvement, and collaboration with Operations and Training teams.

You will work on denials, audits, and performance metrics while ensuring HIPAA and information security standards are upheld. A customer-focused, detail-oriented professional will thrive here.