QA Analyst

Roles & Responsibilities:

• Audit Payment Posting transactions for accuracy.
• Compare system postings with EOBs, ERAs, and payment remittances.
• Verify correct patient, claim, payer, payment amount, and service line.
• Check payments, adjustments, write-offs, denials, refunds, and patient responsibility.
• Identify and document incorrect, duplicate, or missing transactions.
• Validate CARC/RARC and denial codes where applicable.
• Identify underpayments, overpayments, zero-pay, and unapplied cash.
• Classify errors as critical/non-critical and financial/non-financial.
• Provide feedback and coaching to Payment Posting associates.
• Track recurring errors and support Root Cause Analysis (RCA).
• Maintain QA reports, error logs, and audit records.
• Meet defined quality, productivity, and turnaround-time targets.
• Follow SOPs, HIPAA, and data privacy/security guidelines.