Patient Support QA Analyst: Quality & Compliance

Omega Healthcare Management Services Pvt. Ltd.

Indiana (PA)

Hybrid

USD 55,000 - 75,000

Full time

2 days ago

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Job summary

Omega Healthcare Management Services Pvt. Ltd.

is seeking a Quality Assurance Analyst for the Patient Support Contact Center to monitor and evaluate patient-support interactions and case documentation against Omega and client quality standards. The analyst reviews pharmacy benefit, copay and claim-support information, HIPAA practices, documentation quality, professionalism, empathy, and adherence to procedures, partnering with Operations, Training and Quality leadership on calibration and

Qualifications

Two or more years of experience in healthcare, pharmacy billing, patient-support, insurance, or similar contact center environment.
Strong analytical, written, and verbal communication skills.
Working knowledge of U.S. healthcare insurance concepts, including copays, deductibles, coinsurance, and claim responses.
Proficiency with CRM/case management systems and MS Office applications.

Responsibilities

Monitor and evaluate recorded or live patient support interactions and case documentation using approved scorecards.
Assess accuracy of information on copays, deductibles, or benefit verification.
Evaluate pharmacy claim-support activity for adherence to procedures and common rejections.
Ensure HIPAA/privacy practices and proper disclosures are followed.
Escalate critical errors and privacy concerns; participate in calibration sessions.