Healthcare Quality Auditor — Provider Services (Hybrid)

ImagenetLLC; Philippines; On-site; PHP 360,000 - 600,000; Full time

Benefits offered by this job

Comprehensive HMO Coverage- Medical &

HMO coverage on Day 1 plus 1 dependent

Job summary

Imagenet is seeking a Healthcare Quality Auditor for Provider Services in Valero, Makati City. The role conducts audits of provider interactions, documentation, and claims-related work to ensure accuracy, policy compliance, and quality outcomes.

You will collaborate with Operations, Training, Compliance, and other teams to uphold a Zero Error Mindset, calibrate scoring, and drive continuous improvement across the account.

Qualifications

• High school diploma or equivalent required; college degree preferred.
• Minimum 4–5 years in healthcare contact center, provider services, or QA.
• Strong knowledge of healthcare claims, EOBs, eligibility, and payments.
• Ability to interpret QA guidelines and apply scoring criteria consistently.
• Excellent verbal and written communication and attention to detail.

Responsibilities

• Perform quality audits on provider-service interactions and related documentation.
• Apply QA scorecards and guidelines consistently across audits.
• Ensure data accuracy, policy adherence, and timely audit completion.
• Identify risks, document findings, and escalate issues as needed.
• Maintain audit records in QA platforms and reporting trackers.
• Support calibration sessions and provide feedback to teams.

Skills

Quality auditing

Healthcare operations

Data analysis

Attention to detail

Communication

Education

High school diploma or equivalent

College degree preferred

Tools

Microsoft Office

Monday.com

AWS Connect

QA platforms

Call-recording tools

Claims systems

Job description

Imagenet is seeking a Healthcare Quality Auditor for Provider Services in Valero, Makati City. The role conducts audits of provider interactions, documentation, and claims-related work to ensure accuracy, policy compliance, and quality outcomes.

You will collaborate with Operations, Training, Compliance, and other teams to uphold a Zero Error Mindset, calibrate scoring, and drive continuous improvement across the account.