Job Requirements

• High school graduate and above; certification in medical billing or healthcare compliance is a plus.
• 3–5 years of experience in US medical billing, with at least 1–2 years in a quality/auditing role.
• Strong knowledge of CPT, ICD-10, HCPCS codes, and payer-specific billing rules.
• Experience in a call centre environment with exposure to call quality metrics (e.g., AHT, FCR, CSAT).
• Excellent analytical, documentation, and communication skills.
• Proficiency in MS Excel, audit tools, and billing platforms

Responsibilities

• Conduct audits: Perform internal and external audits of products, processes, and services to check for defects, non-conformities, and deviations. 
• Ensure compliance: Verify that products and processes meet internal quality standards and external regulatory requirements. 
• Analyze and report: Compile and analyze data, track metrics, and generate reports on quality performance and audit findings for senior management. 
• Drive improvement: Identify root causes of issues, recommend corrective and preventive actions, and work with teams to implement them. 
• Document findings: Maintain accurate records of audit activities, findings, and recommendations.