Billing Quality Assurance Analyst

Billing Quality Assurance Analyst

Reliable Respiratory is a Durable Medical Equipment (DME) company that provides the highest quality service for patients needing respiratory, diabetes, urology, and maternity support. Equipment provided includes CPAPs, BiPAPs, AutoPAPs, nebulizers, oxygen equipment, ventilators, CGM devices, insulin pumps, and breast pumps.

Each patient is treated with professionalism, understanding, and attentive service. We care about our customers, work closely with the medical community, and have highly skilled staff ready to assist customers in receiving the best care possible.

The Billing Quality Assurance Analyst is responsible for supporting the Billing Department and ensures products and services meet established standards by conducting tests, analysis and quality control of all billing duties performed. This position is fully remote.

Duties and Responsibilities

• Responsible for conducting detailed audits of customer calls, payments, denials, and billing systems to ensure accuracy and adherence to SOPs
• Reviews patient records, billing codes and payment data to identify coding or submissions errors
• Identifies patterns and recurring errors from audit results to pinpoint areas for improvement
• Develops and implements audit plans and quality criteria to evaluate processes and procedures
• Prepare detailed reports on quality metrics and performance trends
• Ensures all billing practices adhere to relevant healthcare regulations (HIPAA) and industry best practices
• Stays updated on coding guidelines, payer requirements and regulatory changes to ensure compliance
• Recommends and drives modifications to operating practices and policies to eliminate quality gaps and improve efficiency
• Monitors team productivity and operational efficiency targets to ensure KPI's are met
• Complete ad-hoc project work as directed by your manager
• Assist in facilitating workload distribution relevant to specific department needs
• Other tasks and duties as required

Basic Qualifications

Required Skills

Competencies

Work Environment & Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.