Job Description:
Conduct routine and random audits of healthcare billing transactions including charges, payments, claims follow-up, denials, and AR activities.
Review daily, weekly, and monthly productivity reports of billing associates.
Validate logged production against actual completed work.
Investigate quota discrepancies, overstatements, duplicate entries, or unsupported outputs.
Monitor AR aging inventory and collector activity.
Audit follow-up actions for unpaid, denied, underpaid, or pending claims.
Ensure adherence to client SOPs, HIPAA standards, internal controls, and company policies.
Monitor completion of required trackers, checklists, and month-end deliverables.
Support implementation of new controls, metrics, and process enhancements.
Prepare QA scorecards, performance dashboards, and error trend analysis.
Present findings to Team Leads, Supervisors, and Management.
Provide structured feedback to employees and leaders based on audit results.
Minimum Qualifications:
Bachelor's degree preferred or equivalent work experience.
Consultancy basis minimum of 6 months consultancy contract (subject for renewal)
Minimum 1–3 years experience in Healthcare Billing, Medical Billing,
Dental Billing, AR, or Revenue Cycle Management.
QA or audit experience in a BPO/shared services environment preferred.
Strong knowledge of claims lifecycle, denials management, AR follow-up, payment posting, and productivity metrics.
Advanced Excel / Google Sheets reporting skills preferred.
Strong analytical, documentation, and stakeholder management skills.
Others:
Equipment/ company computer is provided
Work from Home
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