Quality Analyst

Gear Inc; Muntinlupa; On-site; PHP 480,000 - 720,000; Full time

Job summary

Gear Inc in Metro Manila is seeking a Quality Assurance & Performance Monitoring lead to audit daily transcripts from billers, document results in a standardized tracker, and ensure completeness and consistency of findings.

You will identify patterns, elevate major discrepancies, collaborate with TLs and Trainers for targeted coaching, and support calibration sessions with client and operations teams.

Qualifications

• Fluent in English (C1 or above) with strong communication skills.
• Detail-oriented with strong analytical skills.
• Proficient in MS Office and Google Drive.
• Minimum of 1 year in healthcare AR/revenue cycle or medical billing, with at least 1 year in a leadership role.
• Knowledge of billing practices, payer guidelines, denial management, and HIPAA compliance.
• Strong analytical, decision-making and problem-solving abilities.

Responsibilities

• Audit a daily sample of billers' case transcripts.
• Document audit results in a standardized tracker and ensure completeness and consistency of findings.
• Identify patterns and recurring errors from audit results and elevate major discrepancies or compliance risks to Team Leads or Ops Managers.
• Collaborate with TLs and Trainers to align on recurring issues and plan targeted coaching or refresher training sessions.
• Support calibration sessions to maintain scoring alignment with Client and operational leads.
• Provide clear and structured feedback to specialists based on audit results.
• Handle QA-related inquiries, audit appeals, validate audit logic, and update feedback if necessary.
• Generate and analyze daily, weekly, or ad hoc QA reports to provide insights on team quality trends and process bottlenecks.
• Flag outliers, productivity-to-quality gaps, and compliance risks in collaboration with Operations and Training.
• Prepare QA summaries for client-facing decks and internal reviews as needed.
• Partner with Trainers and Operations to conduct joint root cause analysis and process refinement.

Skills

Leadership

English Communication

Analytical Thinking

MS Office

Google Drive

Billing Knowledge

Tools

Billing systems

Claim portals

Productivity monitoring tools

Job description

Quality Assurance & Performance Monitoring

• Audit a daily sample of billers' case transcripts.


• Document audit results in a standardized tracker and ensure

Completeness and consistency of findings.

• Identify patterns and recurring errors from audit results and elevate major discrepancies or compliance risks to Team Leads or Ops Managers.


• Collaborate with TLs and Trainers to align on recurring issues and plan targeted coaching or refresher training sessions.


• Support calibration sessions to maintain scoring alignment with

Client and operational leads.

• Provide clear and structured feedback to specialists based on audit results.


• Handle QA-related inquiries, audit appeals, validate audit logic, and update feedback if necessary.

Reporting & Insights

• Generate and analyze daily, weekly, or ad hoc QA reports to provide insights on team quality trends and process bottlenecks.


• Flag outliers, productivity-to-quality gaps, and compliance risks in collaboration with Operations and Training.


• Prepare QA summaries for client-facing decks and internal reviews as needed.

Cross-Functional Collaboration

• Partner with Trainers and Operations to conduct joint root cause analysis and process refinement.


• Participate in internal syncs, updates, or policy briefings to stay aligned with client expectations.


• Support internal and external calibration sessions and provide QA representation in client or compliance reviews.

Requirement:

• Fluent in English (C1 level or above), with strong communication and leadership skills.


• Excellent verbal and written communication skills in English, with the ability to express ideas clearly and concisely.


• Be detail-oriented with strong analytical skills;


• Proficient skills with MS Office and Google Drive;


• Minimum of 1 year experience in healthcare AR, revenue cycle, or medical billing, with at least 1 year in a leadership role (external candidate).


• In-depth knowledge of billing practices, payer guidelines, denial management, and compliance standards (e.g., HIPAA).


• Strong analytical, decision-making, and problem-solving skills.


• Comfortable using billing systems, claim portals, and productivity monitoring tools.


• Ability to thrive in a fast-paced, client-driven environment.