Quality Analyst

Gear Inc; Muntinlupa; On-site; PHP 1,454,000 - 2,037,000; Full time

Job summary

A leading healthcare solutions provider is seeking a Quality Assurance Specialist to audit case transcripts, analyze QA reports, and collaborate with team leads. The ideal candidate should be fluent in English, with strong analytical and leadership skills, and possess experience in healthcare revenue cycles. This role requires attention to detail and the ability to work in a fast-paced environment.

Qualifications

• Minimum of 1 year experience in healthcare AR, revenue cycle, or medical billing.
• At least 1 year in a leadership role.
• In-depth knowledge of billing practices and compliance standards.

Responsibilities

• Audit a daily sample of billers' case transcripts.
• Generate and analyze QA reports for insights on quality trends.
• Partner with Trainers and Operations for process refinement.

Skills

Fluent in English (C1 level or above)

Strong analytical skills

Excellent communication skills

Detail-oriented

Proficient with MS Office and Google Drive

Leadership skills

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 escalate 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.

Requirements

• 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.