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.

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.
• Able to work on Holidays is preferable.