Quality Analyst - Healthcare AR/Contract Management

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

Company

hirify.global provides healthcare revenue cycle and related operational services.

What you will do

• Audit project quality processes and monitor client-specific and internal performance metrics.
• Prepare timely reports on audit findings, quality requirements, risks, and performance gaps.
• Identify and implement process improvement methods and plans of correction with quality leads and managers.
• Monitor changes in healthcare laws, regulations, guidelines, and policies affecting clinical documentation and reimbursement.
• Support client presentations, staff education, new-hire training, refresher training, and performance improvement meetings.
• Protect and disclose patient health information only as permitted by HIPAA and internal information-security policies.

Requirements

• At least 1 year of contract management experience.
• Experience training new users and working with outbound payer accounts receivable processes.
• Knowledge of EOBs, CPT, ICD-9 and ICD-10 codes, HCFAs, UB92s, HCPCS, DRGs, authorizations, referrals, denied claims, and appeals.
• 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 is preferred.
• Strong analytical, organizational, communication, problem-solving, computer, and intermediate Excel skills, with the ability to work independently and meet deadlines.

Culture & Benefits

• Collaborative work with Operations, Training, management, and staff teams.
• Participation in continuing education and performance improvement activities.
• Office-based environment with limited noise and standard computer and telephone duties.
• Work requires handling stress, following directions, collaborating, and performing occasional movement and manual tasks.