Hospital Billing Quality Analysts (UB04 QA's) 19th Jun - Hyd

We are looking for Hospital Billing Quality Analysts to join our team at Hyderabad

Job Summary:

The Hospital Billing Quality Analyst is responsible for ensuring accuracy, compliance, and efficiency in hospital billing processes. This role involves auditing and reviewing claims, identifying errors, analyzing trends, and supporting process improvements to reduce denials and enhance reimbursement.

Key Responsibilities:

• Perform quality audits on hospital billing claims to ensure accuracy and compliance with payer guidelines and internal policies.
• Review coding, modifiers, documentation, and charge capture accuracy.
• Identify billing errors such as incorrect charges, duplicate billing, or missed revenue opportunities.
• Analyze trends in denials, rejections, and billing errors to identify root causes and recommend corrective actions.
• Work with billing and coding teams to resolve discrepancies and improve first-pass claim acceptance rates.
• Create and maintain quality performance reports and dashboards.
• Assist in developing training programs and materials to improve billing team performance.
• Ensure compliance with HIPAA, payer regulations, and applicable federal and state laws.
• Participate in internal and external audits and support compliance and risk mitigation initiatives.

Qualifications & Requirements:

• Bachelor’s degree in healthcare administration, finance, or a related field (preferred).
• 4+years of experience with atleast 2yrs of exp in hospital billing, RCM, or medical claims auditing
• Experience with Medicare, Medicaid, and commercial insurance billing guidelines.