Billing Quality/Audit Representative


Quality Analyst works as a member of the Quality Team focusing on workflows, execution excellence, and recommendations. In this role, the analyst works to both proactively to identifying opportunities for process change and make recommendations for enhancements. The analyst will support the Leadership team in providing research, documentation, and recommendations on focus areas under review by the leadership team.

Primary Responsibilities:

  • Review, document and analyze current “as is” processes as requested and make recommendations as appropriate for workflow and/or skill set changes to improve efficiency, improve effectiveness, reduce cost of delivery, reduce cycle time and/or improve quality
  • Perform audits across all operations teams and communicate to leadership any potential opportunities for improvement
  • Maintain and update all policies and processes for operations
  • Using statistical sampling and personal observation, test current compliance with defined workflows and policies, and identify variance found. Compare these results with published results on performance and identify any variances in monitoring reporting
  • Ensure company standards are maintained and product integrity is preserved
  • As identified, research/audit specific cases which may have deviated from the defined workflow and document the process issue, impact to the client and any process or staffing changes that should occur or have occurred as a result
  • Participate as a team member on projects looking at new products, product extensions and enhancements and technology enhancements as needed, providing appeals subject matter expertise
  • Assist in development of special department projects
  • Function as an information source when critical quality issues arise
  • Provide feedback regarding training needs and assist with developing / presenting training materials as needed
  • Perform other duties as may be assigned by management
  • Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so


Required Qualifications:

  • Demonstrated ability to research specific focus areas and provide recommendations that result in improved organizational results
  • Demonstrated ability to work effectively with varying levels within an organization
  • Proven ability to proactively prevent or address issues, and consistent follow-through
  • Strong analytical and problem-solving skills with demonstrated ability to extensively analyze business processes and workflows.
  • Ability to gather and analyze data from multiple sources
  • Strong Computer skills including Microsoft Word, Excel and Power Point
  • Excellent written and verbal communication skills
  • Ability to effectively work and communicate with both internal and external customers in a positive results-oriented manner
  • Ability to identify the cause of an issue, proactively recommend potential solutions to an issue, with analysis of benefits/risks of implementing one solution over another
  • Effective at influencing others to assist in digging into day to day realities without having a direct supervisory role over them
  • Able to quickly learn new processes and to work independently as required
  • Ability to balance conflicting demands and priorities

Preferred Qualifications: 

  • Bachelor’s degree in business or healthcare related field

Salary: ₱15000 - ₱25000
Address: Taguig, Philippines