Quality Assurance Representative

Guidehouse

Quality Analyst responsible for reviewing documentation and billing actions to ensure compliance. Identifying trends and supporting process improvements in account resolution and workflow performance.

Posted 6/30/2026full-timeRemote • Texas • 🇺🇸 United StatesMid-LevelSenior💰 $34,000 - $56,000 per yearWebsite

About the role

Key responsibilities & impact

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.

Requirements

What you’ll need

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

Comp & perks

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

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Account Documentation ReviewBilling Actions AuditDenial Follow-UpProcess ImprovementData Analysis

Soft Skills

CommunicationIndependent WorkProject Initiation