A Hospital Billing Quality Assurance (QA) Analyst ensures the accuracy, compliance, and efficiency of medical billing processes. They audit patient claims, verify medical coding (ICD/CPT), and resolve billing discrepancies to reduce errors and ensure proper reimbursement. Key duties include reviewing records, checking insurance compliance, and improving revenue cycle performance.

Key Responsibilities

- Audit Claims: Audit medical claims, billing records, and payment data for accuracy and regulatory compliance.
- Identify Errors: Detect errors in medical coding, patient charges, and insurer submissions to prevent denials.
- Compliance: Ensure billing adheres to HIPAA, insurance policies, and organizational standards.
- Process Improvement: Recommend improvements to billing workflows to boost accuracy and efficiency.
- Reporting: Prepare detailed reports on audit findings and performance metrics.
- Reconciliation:



Reconcile billing discrepancies and support AR (Accounts Receivable) teams.

Required Skills and Qualifications

- Experience: 2+ years of experience in medical billing, coding, or healthcare finance.
- Knowledge: Strong understanding of medical terminology, ICD-10/CPT coding, and US healthcare insurance (if applicable).
- Tools: Proficiency in Billing Software, Electronic Health Records (EHR) systems, and MS Excel.
- Certification: Certified Skilled Biller (CPB), Certified Professional Coder (CPC), or equivalent preferred.
- Soft Skills: Attention to detail, analytical mindset, and strong communication skills.

Job Scope

These roles are common within hospitals, billing companies, and healthcare providers, often involving US healthcare RCM (Revenue Cycle Management) or domestic billing audits.

📌 AR HB Quality Analyst - Hyderabad (India)
🏢 Eclat Health Solutions
📍 India