The QA Auditor – Billing will be responsible for ensuring the accuracy, consistency, and compliance of all billing-related activities through regular quality audits. This role plays a key role in identifying process gaps, minimizing errors, and supporting continuous improvement within the billing department. The ideal candidate will have strong attention to detail, analytical skills, and a commitment to maintaining high-quality standards. Flexibility to take on additional tasks assigned by the manager is also required.
Responsibilities
Conduct quality audits on billing tasks to ensure accuracy, compliance, and adherence to standards.
Identify errors, inconsistencies, and process gaps, and provide actionable recommendations.
Maintain audit documentation and prepare reports for management review.
Collaborate with the billing team to improve quality, efficiency, and workflow accuracy.
Ensure compliance with internal policies and external billing regulations.
Perform any additional tasks assigned by the manager.
Qualifications/Skills
3–5 years of experience in medical billing (QA/auditing experience preferred).
Strong communication and reporting skills.
High attention to detail and ability to identify process gaps.
Understanding of billing standards, compliance, and documentation requirements.
Interact with US-based clients (billing companies, hospitals, clinics, doctors) through dedicated portals, phone calls, and emails to track communications and resolve issues.
Communicate with US healthcare insurance companies (e.g., Medicare, Medicaid, BCBS) to stay updated on policies and guidelines.
Collaborate with internal departments (Development, Database, QA, Clinical, Billing, IT) to resolve client issues and fulfill enhancement requests.
Ensure quality assurance for client issues and enhancement requests across all software products.
Coordinate with third-party vendors providing additional services like EDI interchange, statement submissions, doctor prescriptions, and lab setups.
Stay updated on the latest trends in medical billing through CMS governing bodies and integrate changes into software products.
Design, customize, and validate specialty-specific clinical templates, encounter forms, order sets, lab orders, letters, and documentation tools.
Design and enhance EHR/EMR workflows, including SOAP notes, macros, labs, and procedures
Set up and validate medication workflows, alerts, and clinical decision support tools to ensure accuracy and relevance.
Training & End-User Support
Conduct remote training sessions for healthcare providers (US-based) and internal teams on clinical workflows, documentation standards, and system functionalities.
Guide users through documentation flows such as HPI, ROS, physical exam, Assessment, and Plan to ensure efficient and compliant usage.
Train staff on AI tools, e-prescribing, and integrated clinical modules to enhance usability and adoption.
Quality Assurance & Compliance
Perform quality assurance checks on clinical workflows, labs, documentation tools, e-prescribing, and integrated modules.
Ensure clinical documentation aligns with regulatory standards, including HIPAA, CMS, and MIPS, while maintaining data privacy and security.
Support internal audits and compliance reviews by adhering to SOPs and regulatory requirements.
Client & Ticket Management
Respond promptly and professionally to internal and external tickets, ensuring detailed documentation and timely resolution.
Monitor client satisfaction, reduce rework, and ensure accurate task execution and delivery within deadlines.
Collaboration & Product Improvement
Work closely with clinicians to understand specialty-specific requirements and implement tailored clinical solutions.
Collaborate with cross-functional teams to contribute to SOP development, audit readiness, and workflow enhancements.
Participate in product testing and user acceptance testing (UAT) and provide structured feedback to support clinical feature improvements.
Qualifications/Skills
Experience in clinical settings or healthcare IT, particularly with EHR/EMR systems, will be preferred.
Proficiency in EHR/EMR systems, with the ability to design and create templates and reports.
Familiarity with healthcare billing and coding processes will be preferred.
Strong clinical knowledge with experience in healthcare IT or EHR/EMR systems.
BDS, or DPT (Non-Practicing).
Familiarity with medical billing, coding, and regulatory compliance.
ONLY DOCTORS WITH COMPLETED EDUCATION TO APPLY (BDS & DPT, Pharmacist )
Timings
5:00 PM – 2:00 AM (Summers)
6:00 PM –3:00 AM (Winters)
Journey
What to Expect
Our hiring process is designed to be smooth, transparent, and efficient. Here’s what you can expect when you apply to join Sequel Technologies:
Step 1: We Will Get in Touch
Once we receive your application, our team will carefully review your profile. If your skills and experience align with our needs, we’ll reach out to you via email or phone to initiate the process.
Step 2: Have a Quick Talk
Next, we’ll schedule an initial conversation to learn more about you. This is a casual discussion where we talk about your background, career goals, and how you can contribute to our team.
Step 3: Schedule Interviews
Based on the initial discussion, we’ll invite you for technical and behavioral interviews with our team. This step helps us evaluate your expertise and see if you’re the right fit for the role.
Step 4: Extend Our Offer
Once you successfully clear the interviews, we’ll extend an offer detailing the role, compensation, and benefits. Welcome aboard – your journey with Sequel Technologies begins!
