Quality Analyst

Responsibilities

• Conduct quality audits on inpatient and observation accounts requiring Notification on Admission (NOA) following sampling guidelines.
• Validate accurate submission of notifications via portals, EDI, fax, or calls and ensure timely non-clinical authorizations.
• Review documentation accuracy, including reference numbers, authorization numbers, payer timelines, and compliance requirements.
• Perform root cause analysis on identified defects and develop CAPA plans to address recurring trends.
• Provide actionable feedback on audit findings and lead performance improvement discussions.
• Prepare daily, weekly, and monthly quality reports to track SLA and accuracy metrics.
• Participate in calibration sessions, refresher initiatives, and training programs.

Requirements

• Minimum of 3 years of experience in US Healthcare Revenue Cycle Management (RCM).
• Strong understanding of Authorization and Notification on Admission (NOA) workflows.
• Prior experience in a Quality Assurance (QA) or Auditor role.
• Mandatory Undergraduate (UG) Degree.
• Willingness to work night shifts.
• Strong analytical, problem-solving, and attention-to-detail skills.
• Excellent communication skills for providing constructive feedback.

Preferred Qualifications

• Experience in Quality Audits specifically within US Healthcare RCM.
• Exposure to multiple RCM functions such as AR, Denials, Charge Entry, or Payment Posting.
• Experience in trend analysis, data interpretation, and quality reporting.
• Familiarity with audit tools, scorecards, and quality metrics.
• Knowledge of HIPAA compliance and industry quality standards.

Benefits

• Competitive compensation package.
• Flexible benefits package.
• Supportive and diverse workplace environment.

About the Company

Guidehouse is a global AI-led professional services firm delivering advisory, technology, and managed services to the commercial and government sectors. We drive efficiency and resilience across the healthcare, financial services, energy, infrastructure, and national security markets.