Quality Analyst - Bilingual (Healthcare)

Location: Onsite at 1 Doña Julia Vargas Ave, Pasig, Metro Manila, Philippines

Company

hirify.global operates in healthcare revenue-cycle and medical billing services.

What you will do

• Audit project quality processes and monitor client-specific and internal performance metrics.
• Prepare detailed reports on audit findings, quality targets, compliance issues, and corrective action plans.
• Identify process risks and improvement opportunities, then implement solutions with QCA leads and managers.
• Collaborate with Operations and Training teams, participate in client presentations, and support performance improvement activities.
• Assist with new-hire, transition, refresher, and outcome-focused training sessions.
• Handle complaints and queries while protecting patient information in accordance with HIPAA and information-security requirements.

Requirements

• At least 2 years of experience as a Quality Analyst in healthcare insurance collections, self-pay collections, call-center customer service, compliance, or training.
• Experience training new users and working with denied claims and appeals.
• Knowledge of EOBs, CPT, ICD-9 and ICD-10 codes, HCFAs, UB92s, HCPCS, DRGs, authorizations, and referrals.
• Understanding of healthcare revenue-cycle operations, including insurance, patient billing and collections, managed care, Medicare, Medicaid, and commercial practices.
• Experience with practice-management systems; EPIC PB, Allscripts, or Cerner experience is preferred.
• Intermediate Excel skills, strong communication and problem-solving abilities, objectivity in staff reviews, and the ability to work independently in a fast-paced team environment.

Culture & Benefits

• Collaborative environment involving Operations, Training, management, and staff.
• Opportunities for continuing education and performance-improvement activities.
• Work includes office-based computer, telephone, and manual tasks in a generally quiet environment.
• Compliance with hirify.global policies, information-security procedures, and HIPAA standards is required.