PHRN Quality Control Analyst (Charge Audit) | PASIG

About Omega Healthcare

Founded in 2003, Omega Healthcare Management Services® (Omega Healthcare) is an AI-driven healthcare solutions company that partners across the healthcare ecosystem to deliver breakthrough results by reimagining and elevating revenue operations. Powered by the Omega Digital Platform®, our agentic AI engine leverages adaptive intelligence to drive automation, complemented by deep human expertise to help optimize performance and deliver sustained financial and clinical outcomes—while enhancing patient satisfaction.

Omega Healthcare empowers organizations across provider, payer, and life sciences sectors to navigate today’s healthcare challenges while building the agility to adapt as healthcare and technology continue to evolve rapidly. Recognized by industry analysts, Omega Healthcare has consistently been ranked a leader in driving operational performance excellence.

Key Responsibilities

• Conduct quality audits and evaluations based on established guidelines and quality standards.
• Monitor and assess customer interactions, transactions, or cases to ensure compliance with client and company requirements.
• Provide timely and constructive feedback to employees and stakeholders regarding audit results.
• Identify quality trends, performance gaps, and areas for improvement.
• Participate in calibration sessions to ensure scoring accuracy and consistency.
• Prepare audit reports, quality summaries, and performance analyses.
• Collaborate with Operations, Training, and other support teams to address quality concerns and improve performance.
• Ensure adherence to compliance, regulatory, and client-specific requirements.
• Assist in developing and recommending process improvement initiatives based on audit findings.
• Maintain accurate documentation of audits, feedback sessions, and quality-related activities.
• Utilize Excel and other reporting tools to track and present quality metrics.
• Support continuous improvement efforts to enhance customer experience and operational performance.

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Qualifications

• Active PHRN license
• At least 2 years of experience as a Quality Analyst (QA) or Quality Control Analyst (QCA) in a healthcare account
• Experience in a Healthcare BPO, healthcare operations, or acute care hospital environment
• Strong background in quality auditing, monitoring, compliance, and performance evaluation
• Experience providing audit feedback, conducting calibrations, and identifying process improvement opportunities
• Knowledge of Prior Authorization, Claims, Appeals, Revenue Cycle Management (RCM), or other healthcare processes is an advantage
• Strong analytical, communication, and reporting skills

Clinical Requirements

• At least 2 years of clinical experience in Cath Lab, Endoscopy, or Operating Room (OR)
• Strong knowledge and experience in an Acute Care Hospital setting
• Experience supporting inpatient, outpatient, and hospital-based services is preferred
• Familiarity with hospital admissions, care coordination, and clinical workflows is an advantage

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Technical Skills

• Proficient in MS Excel (Pivot Tables, VLOOKUP, dashboards)
• Skilled in PowerPoint presentations

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Core Skills

• Strong leadership, coaching, and mentoring skills
• Excellent communication and stakeholder management
• Analytical and data-driven decision-making
• Ability to thrive in a fast-paced, evolving environment