Denials Quality Assurance Specialist

MicroSourcing

Taguig, Philippines

3-5 Years

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Posted 2 days ago
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Job Description

Discover your 100% YOU with MicroSourcing!

Position: Denials Quality Assurance Specialist
Location: Taguig
Work setup & shift: Onsite | Night shift

Why join MicroSourcing

Youu0027ll have:

Competitive Rewards: Enjoy above-market compensation, healthcare coverage on day one (for you and at least one dependent), paid time-off with cash conversion, group life insurance, and performance bonuses.
A Collaborative Spirit: Contribute to a positive and engaging work environment by participating in company-sponsored events and activities.
Work-Life Harmony: Enjoy the balance between work and life that suits you with flexible work arrangements.
Career Growth: Take advantage of opportunities for continuous learning and career advancement.
Inclusive Teamwork: Be part of a team that celebrates diversity and fosters an inclusive culture.

Your Role
As a Denials Quality Assurance Specialist you will:

Support the QA program build by identifying key audit areas, critical workflow aspects, and automation opportunities to enhance efficiency.
Monitor performance metrics, including productivity and accuracy, for all Clinical Denials & Appeals staff.
Escalate production or QA concerns to management and collaborate with Training teams to ensure progress and consistency.
Demonstrate strong knowledge of production workflows, quality processes, and documentation standards in medical diagnoses and treatment practices.
Conduct QA audits, maintain detailed QA records, and provide constructive feedback to team members.
Mentor staff to improve performance, engagement, and job satisfaction.
Review reports on production and accuracy, offering actionable insights and coaching for continuous improvement.
Collaborate with Operations, Training, and HR to align onboarding, performance metrics, and training outcomes.
Participate in client calibration calls, internal audits, and process reviews, representing QA achievements and performance trends.

What You Need
Non-negotiables

At least 1 year of experience in QA or auditing for clinical appeals writing within a BPO or healthcare setting.
3-5 years of acute care clinical experience in a hospital setting (Med/Surg or similar preferred

More Info

Job Type:

Permanent Job

Industry:

IT /Computers - Software

Function:

Healthcare

Employment Type:

Full time

About Company

MicroSourcingJob Source: www.microresumes.com

Founded in 2006, we pioneered a new way of offshoring. This model involves setting up an overseas division of your company and getting a local specialist to handle facilities, IT, labor laws, recruitment and HR, while you retain control over quality and productivity. Today, we&#8217;re still one of the largest and most experienced offshoring providers in the Philippines, with 400+ active clients and 6,000+ employees. We operate within purpose-built, class-A facilities that are strategically located for access to Manila&#8217;s most talented people. We&#8217;re backed by our Australian parent company, Probe and we&#8217;re ISO certified.

Job ID: 135560047

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