Medical Billing QA Analyst

Healthrix is seeking a detail-oriented Medical Billing QA Analyst to join our expanding team. The ideal candidate will have a strong background in Revenue Cycle Management (RCM) and a passion for quality assurance. This role focuses on ensuring accuracy and compliance in medical billing processes, minimizing revenue leakage, and supporting operational excellence. If you are committed to maintaining high standards and improving billing workflows, this opportunity is for you.

Key Responsibilities:
- Audit medical billing and RCM transactions for accuracy and regulatory compliance.
- Review CPT, HCPCS, ICD-10 codes, modifiers, documentation, and claim details thoroughly.
- Conduct audits on claim submissions, rejections, denials, accounts receivable (A/R), and payment postings.
- Identify billing errors, detect trends, and uncover potential revenue leakage.
- Perform root cause analysis (RCA) and recommend corrective actions to address issues.
- Ensure adherence to HIPAA, CMS guidelines, payer policies, and internal standard operating procedures (SOPs).
- Prepare QA scorecards, audit reports, and KPI dashboards to track performance metrics.
- Monitor key indicators such as accuracy, productivity, denial rates, rejection rates, and turnaround times (TAT).
- Provide constructive feedback and coaching to billing and A/R teams to enhance performance.
- Support ongoing process improvements, update SOPs, and assist in staff training initiatives.

Required Qualifications:
- Bachelor’s degree from a recognized institution.
- Experience with Electronic Health Records (EHR), Electronic Medical Records (EMR), or specific tools such as eClinicalWorks (ECW).
- Solid understanding of Revenue Cycle Management (RCM) processes.
- Proficiency in Microsoft Office applications.
- Strong verbal and written communication skills.
- 2 to 3 years of relevant experience in medical billing quality assurance or a related field.

Job Location and Details:
This is a full-time, in-person position based in Lahore. Candidates should be willing to work night shifts as required. The role offers a competitive monthly salary ranging from Rs70,000 to Rs100,000.

Healthrix provides a dynamic work environment where quality and compliance are prioritized. Join us to contribute to improving billing accuracy and operational efficiency within a growing healthcare organization.