Quality Assurance Representative

Job Family:

Travel Required:

Clearance Required:

What You Will Do:

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.

What You Will Need:

• High School Diploma / GED or 3 years of Relevant Equivalent Experience in Lieu of Diploma / GED.

• 0-2 years experience in office business operations customer service or healthcare field.

What Would Be Nice To Have:

• Previous experience working in insurance portals

• PC skills in a Windows environment.

• Knowledge and utilization of desktop applications to include Word and Excel.

• Ability to initiate and follow through on projects and work independently with minimal supervision

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What We Offer:

Guidehouse offers a comprehensive total rewards package that includes competitive compensation and a flexible benefits package that reflects our commitment to creating a diverse and supportive workplace.

Benefits include:

• 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

About Guidehouse

Guidehouse is an Equal Opportunity EmployerProtected Veterans Individuals with Disabilities or any other basis protected by law ordinance or regulation.

Guidehouse will consider for employment qualified applicants with criminal histories in a manner consistent with the requirements of applicable law or ordinance including the Fair Chance Ordinance of Los Angeles and San Francisco.

If you have visited our website for information about employment opportunities or to apply for a position and you require an accommodation please contact Guidehouse Recruiting at 1- or via email at . All information you provide will be kept confidential and will be used only to the extent required to provide needed reasonable accommodation.

All communication regarding recruitment for a Guidehouse position will be sent from Guidehouse email domains including @ or . Correspondence received by an applicant from any other domain should be considered unauthorized and will not be honored by Guidehouse. Note that Guidehouse will never charge a fee or require a money transfer at any stage of the recruitment process and does not collect fees from educational institutions for participation in a recruitment event. Never provide your banking information to a third party purporting to need that information to proceed in the hiring process.

If any person or organization demands money related to a job opportunity with Guidehouse please report the matter to Guidehouses Ethics Hotline. If you want to check the validity of correspondence you have received please contact . Guidehouse is not responsible for losses incurred (monetary or otherwise) from an applicants dealings with unauthorized third parties.

Guidehouse does not accept unsolicited resumes through or from search firms or staffing agencies. All unsolicited resumes will be considered the property of Guidehouse and Guidehouse will not be obligated to pay a placement fee.