Qa Specialist

Description:

Macrise Tech Solutions Pvt Ltd is a trusted partner to leading US-based behavioral health providers. We pride ourselves on delivering excellence in healthcare support services and are committed to fostering a dynamic, growth-oriented work environment where every team member plays a vital role in improving patient care.

Position Summary

We are seeking a detail-oriented and dedicated QA Specialist – Medical Billing (Behavioral Health) to join our quality assurance team onsite in Lahore. This critical role involves ensuring the accuracy, compliance, and overall quality of medical billing processes within the behavioral health domain. If you have a keen eye for detail, passion for process improvement, and a deep understanding of medical billing intricacies, especially related to behavioral health, this position offers a great opportunity to grow your career while making a meaningful impact.

Key Responsibilities

• Conduct thorough audits and monitor the performance of medical billing functions, including:

  • Eligibility & Benefits Verification

  • Authorizations & Intake Review

  • Charge Entry & Claims Submission

  • Payment Posting

  • Denial Management & Accounts Receivable Follow-up

  • Patient Collections

  • Credentialing & Re-Credentialing

• Identify and report process gaps and documentation errors to improve billing accuracy.

• Provide timely and constructive feedback to billing team members to enhance performance.

• Ensure strict adherence to HIPAA regulations and maintain data confidentiality.

• Maintain and update QA dashboards, tracking key metrics and reporting on quality performance.

Qualifications and Skills

• Proven experience in medical billing quality assurance, preferably within the Behavioral Health sector.

• Strong familiarity with billing systems such as Office Ally, Availity, and AdvancedMD.

• Understanding of US insurance payers, billing procedures, and denial management patterns.

• Exceptional attention to detail and commitment to accuracy.

• Excellent communication skills and accountability in all tasks.

• Willingness to work onsite in Lahore during night shifts (6:00 PM to 3:00 AM Pakistan Time).

Why Join Macrise Tech Solutions?

• Work in a supportive and dynamic environment that values professional growth.

• Be part of a team that directly impacts the quality of healthcare services.

• Enjoy a stable, long-term career opportunity with competitive compensation.

• Contribute meaningfully to improving patient care through precise and compliant medical billing.