Quality Auditing Analyst, Taguig

Description

Job Requirements

High school graduate and above; certification in medical billing or healthcare compliance is a plus.
35 years of experience in US medical billing, with at least 12 years in a quality/auditing role.
Strong knowledge of CPT, ICD-10, HCPCS codes, and payer-specific billing rules.
Experience in a call centre environment with exposure to call quality metrics (e.g., AHT, FCR, CSAT).
Excellent analytical, documentation, and communication skills.
Proficiency in MS Excel, audit tools, and billing platforms

Responsibilities

Conduct audits: Perform internal and external audits of products, processes, and services to check for defects, non-conformities, and deviations.
Ensure compliance: Verify that products and processes meet internal quality standards and external regulatory requirements.
Analyze and report: Compile and analyze data, track metrics, and generate reports on quality performance and audit findings for senior management.
Drive improvement: Identify root causes of issues, recommend corrective and preventive actions, and work with teams to implement them.
Document findings: Maintain accurate records of audit activities, findings, and recommendations.

Highlights

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