Medical Billing Quality Analyst

**Job Title: Medical Billing Quality Analyst (US-Based Revenue Cycle Management Company)**

**Location:** Virtual (Work from Home – Philippines)

**Salary:** $6 – $9 per hour (USD)

**Job Type:** Full-Time

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**About Us:**
We are a US-based Revenue Cycle Management Company offering top-tier billing and coding services for healthcare providers. We are expanding our team and looking for an experienced and detail-oriented **Medical Billing Quality Analyst** to help ensure the accuracy, compliance, and efficiency of our medical billing processes. This is a high-demand role with a focus on thorough analysis and reporting.

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**Job Description:**
As a Medical Billing Quality Analyst, your primary responsibility will be to review, analyze, and audit medical billing data for accuracy, compliance, and completeness. You will work closely with the billing team to identify issues in claims processing, resolve rejections and invalid submissions, and ensure that all claims meet the highest standards of quality. This is a key role in maintaining the integrity of the billing process, and your expertise will be crucial in identifying areas for improvement and making recommendations.

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**Key Responsibilities:**
- Perform audits and quality reviews of outpatient claims, ensuring they are processed accurately and in compliance with applicable regulations.
- Analyze and resolve claim rejections, invalid submissions, and clearinghouse issues.
- Identify and communicate trends or recurring issues within billing processes.
- Provide clear and concise reports on findings, highlighting areas that require attention or improvement.
- Collaborate with the billing and coding teams to resolve discrepancies and optimize processes.
- Evaluate and ensure proper coding for services in Family Practice, Internal Medicine, Pain Management, Lab, Surgery, Interventional Radiology, and Neurology.
- Perform in-depth analysis of EMR (Electronic Medical Records) data and generate reports based on findings.
- Stay up-to-date with changes in coding standards, billing guidelines, and payer requirements.

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**Requirements:**
- Certified Professional Coder (CPC) or similar medical coding certification preferred.
- Minimum of 2 years of experience in Medical Billing and Quality Analysis, specifically with outpatient claims.
_ Must have a reliable at-home work setup:
Computer with up-to-date software and hardware.
High-speed internet connection.
Headset for clear communication
- Strong knowledge of medical coding (ICD-10, CPT, HCPCS) and billing procedures.
- Prior experience in Family Practice, Internal Medicine, Pain Management, Lab, Surgery, Interventional Radiology, or Neurology is highly beneficial.
- Proficiency with EMR systems and generating reports from EMR platforms.
- Comfortable working with clearinghouses and resolving claims rejections and invalid submissions.
- Strong analytical skills and ability to identify, analyze, and resolve billing issues efficiently.
- Ability to clearly communicate findings and recommendations verbally and in writing to the team.
- Experience with high-volume claims and working within strict deadlines.
- Ability to work independently and efficiently in a fast-paced environment.
- Proficient in Excel and other basic office software (creating spreadsheets, reports, etc.).

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**Additional Information:**
- This is a full-time, remote position (work from home).
- You will be working in a high-demand environment with deadlines and a focus on efficiency and quality.
- Competitive hourly rate based on experience.
- Opportunity for growth and career advancement within the company.

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**How to Apply:**
If you are a detail-oriented professional with experience in medical billing quality analysis and outpatient claims, we want to hear from you! Please submit your resume along with a cover letter that highlights your relevant experience and coding certification.

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**Note:** Only applicants with previous experience in medical billing and quality analysis for US-based companies will be considered. We look forward to reviewing your application! Wages will be based on experience.