Guidehouse, a "next-generation consultancy" and a portfolio company of Veritas Capital, provides management, risk consulting, and technology services to help cl
Quality Assurance Representative
Location
Texas
Posted
5 days ago
Salary
$34K - $56K / year
Seniority
Senior
Job Description
Quality Assurance Representative
Guidehouse
• 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. • 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.
Job 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
- Previous experience working in insurance portals (nice to have)
- PC skills in a Windows environment (nice to have)
- Knowledge and utilization of desktop applications to include Word and Excel (nice to have)
- Ability to initiate and follow through on projects and work independently with minimal supervision (nice to have)
Benefits
- Medical, Rx, Dental & Vision Insurance
- Personal and Family Sick Time & Company Paid Holidays
- Position may be eligible for a discretionary variable incentive bonus
- 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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