Quality Analyst (Healthcare)

TL;DR

Quality Analyst (Healthcare): Performing quality auditing, risk identification, and reporting for healthcare insurance collections with an accent on revenue cycle operational processes and compliance. Focus on auditing denials analyst performance, implementing process improvements, and ensuring adherence to HIPAA standards.

Location: Onsite in Pasig, Metro Manila, Philippines

Company

hirify.global is a provider of healthcare revenue cycle management and clinical documentation services.

What you will do

• Conduct quality auditing and analysis of denials analyst performance to ensure internal and client metrics are achieved.
• Prepare and deliver detailed reports on audit findings and quality targets in a timely manner.
• Identify and implement process improvement solutions in consultation with QCA leads and managers.
• Monitor changes in laws, regulations, and policies impacting clinical documentation and reimbursement to ensure compliance.
• Support new hire training, transition periods, and refresher training sessions.
• Manage patient protected health information (PHI) in strict accordance with HIPAA standards.

Requirements

• At least 2 years of experience as a Quality Analyst in healthcare insurance collections, self-pay collections, or call center compliance.
• Knowledge of medical coding (EOBs, CPT, ICD-9 & 10, HCPCS, DRGs) and authorization/referral processes.
• Strong understanding of healthcare revenue cycle processes, including Medicare, Medicaid, and Commercial Practices.
• Experience with practice management systems; Epic PB, Allscripts, or Cerner preferred.
• Proficiency in Microsoft Office Suite, specifically intermediate Excel skills.
• Must be based in Pasig, Metro Manila, Philippines.

Culture & Benefits

• Professional environment focused on teamwork and service excellence.
• Opportunities for continuing education to maintain credentials and enhance skills.
• Collaborative workflow with regular engagement with Operations and Training teams.
• Commitment to a non-discriminatory workplace based on federal and local laws.