Quality Assurance Representative
Guidehouse•Lewisville, TX
•$34,000 - $56,000•Onsite
About The Position
The Quality Analyst role is responsible for reviewing account activity, documentation, billing actions, denials, adjustments, and follow-up processes to ensure accuracy, compliance, and consistency with client and departmental expectations. This role supports quality improvement by identifying trends, documenting findings, and communicating issues that may impact account resolution or workflow performance.
Requirements
- High School Diploma / GED or 3 years of Relevant Equivalent Experience in Lieu of Diploma / GED.
- 0-2+ year's experience in office, business, operations, customer service or healthcare field.
Nice To Haves
- Previous experience working in insurance portals
- PC skills in a Windows environment.
- Knowledge and utilization of desktop applications to include Word and Excel.
- Ability to initiate and follow through on projects and work independently with minimal supervision
Responsibilities
- Review account documentation to ensure notes are complete, accurate, and entered in the appropriate client system.
- Audit billing, rebilling, denial follow-up, appeal activity, adjustments, and account resolution actions for accuracy and compliance.
- Monitor denials, correspondence, and account trends to identify recurring issues or process gaps.
- Validate that demographic, insurance, address, and plan updates are completed correctly and support account integrity.
- Ensure work aligns with applicable client requirements, standard operating procedures, HIPAA guidelines, and state or federal regulations.
- Document QA findings clearly and communicate trends, errors, or concerns to leadership for review and follow-up.
- Support special projects, training opportunities, and process improvement efforts related to quality, accuracy, and workflow performance.
Benefits
- Medical, Rx, Dental & Vision Insurance
- Personal and Family Sick Time & Company Paid Holidays
- Parental Leave
- 401(k) Retirement Plan
- Basic Life & Supplemental Life
- Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
- Short-Term & Long-Term Disability
- Tuition Reimbursement, Personal Development & Learning Opportunities
- Skills Development & Certifications
- Employee Referral Program
- Corporate Sponsored Events & Community Outreach
- Emergency Back-Up Childcare Program
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
