Quality Assurance Representative

Responsibilities 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. Qualifications High School Diploma / GED or 3 years of Relevant Equivalent Experience in lieu of Diploma / GED. 0–2+ years of experience in office, business, operations, customer service or healthcare field. Nice to Have Previous experience working in insurance portals. Proficiency with Windows environment and desktop applications like Word and Excel. Ability to initiate and follow through on projects and work independently with minimal supervision. Benefits Medical, Rx, Dental & Vision Insurance. Personal and Family Sick Time & Company Paid Holidays. Position may be eligible for 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. Equal Opportunity Employer Guidehouse is an Equal Opportunity Employer–Protected 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. #J-18808-Ljbffr US104 Guidehouse Managed Services LLC