
Quality Analyst
6 days ago
The QA Specialist – Medical Billing is responsible for reviewing and auditing billing and coding processes to ensure compliance with industry standards, payer policies, and client-specific requirements. This role plays a crucial part in maintaining high levels of accuracy and quality in all billing-related activities.
Key Responsibilities:
- Conduct regular audits of medical claims, coding, and billing documentation for accuracy and compliance.
- Identify billing errors, coding discrepancies, and process inefficiencies.
- Work closely with billing, coding, and AR teams to provide feedback and suggest corrective actions.
- Maintain up-to-date knowledge of CPT, ICD-10, and HCPCS codes, payer guidelines, and industry regulations (HIPAA, CMS, etc.).
- Generate QA reports and track performance metrics related to quality benchmarks.
- Participate in training sessions and help develop QA procedures and best practices.
- Collaborate with internal departments to implement continuous improvement initiatives.
Requirements:
- Associate's or Bachelor's degree preferred.
- Minimum of 2+years of experience in medical billing, coding, or QA in a healthcare environment.
- Knowledge of medical terminology, EHR/EMR systems, and insurance billing practices.
- Certification in medical coding (e.g., CPC, CCS, or similar) is a plus.
- Strong analytical skills and attention to detail.
- Proficient in Microsoft Excel, Word, and billing software.
- Excellent written and verbal communication skills.
For Enquires:
Job Types: Full-time, Fresher
Benefits:
- Health insurance
- Provident Fund
Work Location: In person
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