The Quality Analyst is responsible for ensuring accuracy, compliance, and efficiency across medical billing processes. This role involves conducting audits, analyzing claims and documentation, identifying improvement opportunities, and collaborating with the team to maintain high standards of billing performance. The ideal candidate maintains strong attention to detail, excellent communication skills, and the flexibility to adapt to evolving business needs.
Key Responsibilities:
Quality Audits & Compliance
Conduct quality audits on medical billing processes, claims, and documentation to ensure accuracy, compliance, and adherence to industry standards and regulatory requirements.
Review and analyze medical records, claims, pre-billing activities, coding, and billing data to identify errors, discrepancies, and areas for improvement.
Stay updated on changes in medical billing regulations, coding guidelines, and industry best practices to ensure ongoing compliance.
Process Improvement & RCA
Perform Root Cause Analysis for recurring issues and implement corrective and preventive actions.
Participate in meetings, discussions, and cross-functional initiatives to identify process improvement opportunities.
Assist in resolving complex billing issues, denials, and appeals.
Quality Control & Reporting
Develop and maintain quality control procedures, guidelines, and checklists for consistent and accurate billing practices.
Monitor and track key quality metrics and prepare reports for management, highlighting trends, concerns, and recommended corrective actions.
Maintain Turnaround Time standards while upholding accuracy and quality expectations.
Team Collaboration & Training
Collaborate with team members to provide feedback, training, and guidance related to accuracy, documentation quality, and regulatory compliance.
Offer support to team and leadership as needed and adapt to evolving business requirements.
Professional Attributes
Demonstrate strong communication skills and the ability to interact effectively with internal teams and stakeholders.
Exhibit flexibility to work from the office as required to support operational and organizational priorities.
Show the ability to take on varied responsibilities and contribute proactively to team success.
Required Skills & Competencies
Strong understanding of medical billing, coding, and compliance guidelines
Excellent analytical and auditing skills
Attention to detail and accuracy in reviewing documentation
Proficiency in identifying process gaps and implementing corrective actions
Strong verbal and written communication skills
Ability to manage deadlines and maintain TAT
Ability to work independently and collaboratively
EDUCATION: Any Graduation in any discipline from a reputed college
LOCATION: Eco Space, Bellandur (Bangalore)
NOTE: Work from office
DESIGNATION: Quality Analyst
TRANSPORT : 6:30 PM to 3:30 AM (Office Transport will Be provided)
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