Job Summary

The QA – Physician Billing is responsible for ensuring accuracy, compliance, and quality of AR processes related to physician billing. The role focuses on auditing AR work, identifying trends in denials and underpayments, ensuring adherence to payer guidelines, and driving process improvements to maximize reimbursements.

Key Responsibilities

Perform quality audits on Physician Billing AR work including follow-ups, appeals, and payment postings

Review EOBs, ERAs, and payer correspondence for accuracy and compliance

Validate correct application of payer rules, contract terms, and coding guidelines

Identify root causes of denials, underpayments, and write-offs

Track and report QA scores, error trends, and performance metrics

Provide feedback, coaching, and corrective action plans to AR teams

Ensure compliance with HIPAA, payer policies, and internal SOPs

Support process improvement initiatives and best practices

Assist in training recent AR staff on quality standards

Collaborate with Team Leads, Managers, and Coding teams to resolve issues

📌 PB-QA (5 Jan 26) (India)
🏢 Eclat Health Solutions
📍 India